health

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A surprise Monday post

It’s Monday morning, and I didn’t bring my little laptop computer back to the house with me this weekend‒mainly just because I hadn’t brought it all week last week, and so I was just sort of “in that mode” when I left the office on Saturday‒and so I’m not doing any editing this morning on Extra Body.  It’s possible, of course, for me to edit it via the smartphone based Word app, but the few times I’ve used that, I found it cumbersome and unpleasant.  So, I decided I would write a random blog post on my smartphone, using Google Docs, for “old times’ sake”.

I’m already somewhat tired of editing and working on Extra Body, and I haven’t even finished the third edit (I’m about 20 pages from the end of that).  I will try to complete at least that much this week, but after that, I don’t know.  I just don’t feel that interested in it anymore.  I honestly don’t feel that interested in anything anymore.  Everything is boring or irritating or frustrating or some combination thereof.  Even reading nonfiction about topics in which I have long-standing interest is basically almost more of a chore than a pleasure.  If you know me at all, you know that’s a true departure, and is surely atypical.  I just have no interest in things in general.  That fact doesn’t even feel sad, to me.  It doesn’t feel like anything that’s being or been lost.  It feels like something that’s long since gone, if it ever existed in the first place.

This week will see the Autumnal equinox and the beginning of Fall/Autumn (in the northern hemisphere), but here in South Florida, it’s still so hot and muggy that I’m sweating just from sitting here and waiting for the train.  And I’m not talking about a little dampness in the armpits.  I’m talking about needing to wipe my eyes frequently because of the sweat dripping down into them, and sometimes dripping onto the inside surface of my reading glasses.  I’m wearing a shirt designed for athletes, with that cooling, “wicking” nature, and I have a change of shirt for the office.  Honestly, I wonder if I shouldn’t have brought a change of underwear.

I know, I complain about the hot, muggy weather here quite a lot, but it really is annoying.  There are long stretches of the year in which it is not just unpleasant to do any kind of exercise outdoors, but it is actually dangerous, because one overheats and dehydrates so quickly.  Presumably, it’s only going to get worse down here over the years, but at least that won’t apply to me.

In other weather related stuff, I’ve been trying to initiate the habit of riding my bicycle.  I’ve adjusted the seat to a better height for me (it required buying and using a pipe cutter, but that worked and it is much better now), and I got some new, high quality headlights and taillights, and I was all set to ride it some yesterday…and then, just as I was finishing up my laundry, thunderstorms rolled in, and they dominated the weather for the rest of the day.

It may take one much longer to get anywhere when walking‒or even jogging‒compared to biking, but at least it is less impacted by rain.  You can always carry an umbrella when walking, and you can avoid the worst puddles and such by stepping carefully.  And parkas work much better when on foot (at least in my experience) than when biking.  If you have a computer in your backpack and you’re caught in a serious rainfall, it’s much easier to protect that computer when on foot than when riding a bicycle.

Not that I have any experience with this.

Of course, walking has its own issues.  I did a bit of fairly serious walking last week, and I’m having some surprising and quite uncomfortable left heel/plantar fascia pain.  That’s extremely annoying, and it is probably the result of some relative postural mismatch on the length and/or configuration of my walking.  Certainly, based on the pattern of wear on my shoes, I put pressure on the outer ball of my right foot much more than the rest of that foot, and the heel of my left more than the ball.  This is a long-standing pattern, and may be produced by even very mild anatomic and/or gait-related asymmetry.

Still, I already had/have heel inserts for shoes, specifically intended to counter issues with the plantar fascia, and I have them in, today.  We shall see if and to what degree they soothe that problem.  If they do not, then I may have to revert to not wearing socks, which (to my surprise) seems to ease many of my foot and even leg problems, though it entails a significant temporary increase in blisters and, of course, given the heat and humidity of south Florida, makes shoes wear out quite a bit faster.  If you do it, I encourage generous use of Lysol; just pretend you’re a bowling alley attendant every time you take off your shoes.

We’ll see what ends up being the best option, at least for the time being.

And now, it’s almost time for my train to arrive, so I’ll call this all good for the day.

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By medicine life may be prolong’d, yet death will blog the doctor too.

Hello and good morning.  It’s Thursday, and so—as I mentioned yesterday that I would—I’m writing a standard blog post.

I’m writing in the back of an Uber right now, but I’m using my laptop, and that combination is a first for me, I think.  I know that taking Ubers is probably an unjustifiable expense, and I mean to cut back on them, but this week I’ve had very little useful energy*, and anyway, I’m only too happy just to burn through the quite small amount of money that I have, since I have no reason to save for the future.

I was briefly puzzled as I did the initial “save” for this document, since I save my blogs by date and day of the week, when I saw that last year the 23rd of May fell on a Tuesday, not a Wednesday.  Each year generally shifts the day (of the week) of any given date one day later than the previous year, since a standard year is one day longer than a multiple of 7: [52 x 7 = 364].  I think that the official mathematical term is “modulo” when you’re just looking at the remainder.  And I vaguely recall noting, earlier this year, that the dates this year were one day later.

But, of course, this is a leap year, in which we “add” a day to the year, specifically on February 29th.  So it makes sense:  early in the year, this year’s dates are one weekday later than they were last year, but after the end of February, they are two days later.  I suppose that means that next January and February will be two days later than they were this year, but after that things will revert to one day later.

Hold on to your hats, folks!  If the whole blog post is this exciting, goodness knows how you’re going to be able to stand it.

It’s a bit tricky writing in the back seat here, because my laptop computer doesn’t have illuminated keys.  When the bouncing around of the car throws me off too much, I have to re-find my typing location by trial and error.  Once I do, I don’t really need to be able to see; I know my way around the keyboard pretty much by proprioception.  After all, I’ve been typing at least since I was eleven.

Not to say that I don’t make plenty of typos.  My coordination isn’t all that great, and I often get ahead of myself.  But at least with modern word processors, it’s so easy to correct for errors that it’s not a big deal.

Actually, I suspect that if I’d been forced to keep using my grandmother’s typewriter, which is what I used to start my typing career, and on which I needed to use correction film to erase mistakes, I would probably be a better, or at least cleaner, typist than I am now.  Once word processing programs came into play, there was no longer as much of a price to pay for minor errors, and so there was less pressure to be more accurate.  As I’ve noted many times, everything responds to local pressures and incentives and disincentives.

I warned you that this might be exciting, didn’t I?

I almost didn’t go in to work today.  That was why I let myself get the Uber:  to help me to clear that activation energy barrier.  I am not particularly physically sick, though I feel a bit of a tickle in the back of my throat.  I just didn’t want to go in.  Yesterday, all day, I was extremely tense and stressed out, and the noise was particularly irksome, and I had payroll to do, and I was always just sliding along what felt like the razor edge of a true breakdown or explosion.  Yet no one seems to have noticed.

I banged my head on the wall quite hard at one point, and did several other things to cause myself pain throughout the day.  I don’t want to go into specifics too much; I don’t want people to think I’m a weirdo or something.

Ha.  Ha.  Ha.  Ha.  Ha.

Anyway, I’ve actually just arrived at the office.  I hope my hands and thumbs won’t feel too sore, today.  Yesterday, my thumb bases were painfully tight, and most of the rest of my finger joints were sore and stiff, albeit to a lesser degree than the thumbs.  It made it quite difficult to try to play guitar, so I didn’t do much of that.

Actually, because of the trouble with my hands, and my shoulders, and of course, the ongoing issues with my back and hips and knees and ankles—especially with my back—I decided to buy a huge bottle of Ibuprofen, and I’ve taken some of them starting yesterday afternoon.

I have been “off” Ibuprofen for quite some time, now, though it was my go-to anti-inflammatory for many years.  I started to avoid it when its use was associated on two or three occasions—possibly just by coincidence—with a relatively high occurrence of what I presume were premature atrial contractions, with associated palpitations.  It was nothing terribly severe, of course, but at the time, I wanted to live, so I switched mainly to naproxen.

I also use some aspirin, as well as acetaminophen for headaches and other things that don’t benefit from any suppression of cyclooxygenase.  But, despite its longer action, naproxen has never worked quite as well as ibuprofen seemed to work, though perhaps that’s been confounded by other variables.  It’s hard to do a double-blind test on oneself.

In any case, at this point, I don’t much care if I get palpitations, although if they happen, maybe I’ll find them unpleasant enough that I’ll change my mind.  Frankly, I don’t mind if I have a full-fledged arrhythmia.  Sudden cardiac death due to ventricular fibrillation, for instance, is probably one of the best ways to die.  You basically just faint, since your brain is no longer getting blood flow, and that’s that.  If no one defibrillates you, and if the arrhythmia doesn’t spontaneously resolve, you’re done.

It’s probably not quite as quick a death as being at ground zero of a thermonuclear explosion, and it’s certainly not as quick as being obliterated when the vacuum energy of the universe quantum tunnels down to a lower level**, since that process would spread throughout the cosmos at the speed of light, and no information within spacetime can exceed the speed of light, so it’s fundamentally impossible to know such an event is happening before it arrives.  It’s also impossible to know about it once it arrives, since everything currently existing in our universe, right down to fundamental particles, would by obliterated by the vacuum state decay—again, at the speed of light, which is far faster than the rate at which the nervous system can experience anything.

Unfortunately, even more than the thermonuclear explosion possibility, vacuum decay would involve taking other, “innocent” people along with me, at least some of whom both wish and deserve to continue living.  That seems a bit unethical—or at least rude, which I sometimes think is worse—and anyway, it’s not as though anyone knows how to make it happen.

It’s better to keep things confined to my person.

I guess even a hemorrhagic stroke wouldn’t be too bad, to be honest, and given my tendency to bang my head against the wall when I get too frazzled and stressed, it seems immensely more likely than vacuum state collapse.  I suppose I could even tolerate death by bleeding ulcer, though I really don’t like nausea***.

Probably, though, in the end, I’m going to have to take a more active and deliberate hand in things.  I suppose we’ll see.  It’s hard to work up the courage to face the discomfort and even frank pain associated with most such interventions, but practice makes better, and I already have a fair amount of experience deliberately causing myself pain, as noted above.

That’s enough blog post for now.  I’ve already droned on and on.  My tentative plan is to do some fiction writing tomorrow morning, and if I do (or even if I don’t) I plan to leave a little report about it here.  I am off work this weekend, so I won’t be writing anything on Saturday (barring, as always, the unforeseen).

I truly, honestly, and fervently hope that each and every one of you feels better than I do right now, and I mean substantially better.  You probably do; it seems likely that, in the phase space of physical and emotional states, there are many more possibilities in that direction than in the other.  But I could be wrong.

TTFN

Addendum:  While editing, I found that MS Word had underlined a sentence in the draft above, in which I wrote, “I think that the official mathematical term is….”  The editor gave the comment that “expressing opinions with certainty adds formality”.  I don’t think I could possibly disagree more than I do with that sentence. 

Bad advice in editor marked up

 PLEASE DON’T DO THAT, PEOPLE!!!!!!!!  Opinions are opinions.  Expressing them with certainty when you are not certain is tantamount to outright lying, and is a huge problem with human discourse!  I’m ashamed of MS Word for making that suggestion.  What a horrible, horrible recommendation!  What a nightmarish thing to say!

*And yet, my level of tension has been exceptionally high.  That’s a frustrating bit of irony, as I probably don’t need to tell you.

**This is purely a hypothetical possibility.  The vacuum energy of the universe may well be at its lowest/ground state, though it is patently not quite zero.  If it were, cosmic expansion would not be accelerating.  Indeed, I often say that cosmic inflation is happening now, based on all the data we have.  That’s what “dark energy” is doing, albeit at a slower rate than what is proposed to have happened 13.7 billion years ago.

***Weird, right?  I don’t like nausea?  How unusual!

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Both my ears are ringing down the curtain

I’m planning on writing at least a page on Extra Body once I get to the office, but I haven’t left yet, and so I’m starting on a bit of a blog post, which I plan to finish with an update on what I write.  I don’t want to get out the laptop computer and use it at the house before I leave.

I have some unfortunate news‒unfortunate for me, at any rate, though it may not matter much to anyone else.  Yesterday, May 9, 2024 AD, at roughly 3:25 pm Eastern time, I suddenly began to have tinnitus in my left ear, matching what I have had in my right ear since…about 2007, I think.  I have very poor hearing in my right ear as part of that process, and it’s hard to tell what’s going on with my left, so far.  I can only say that it’s quite distressing.  I felt like I wanted to scream in the office yesterday afternoon, when it happened.  I still want to scream.  It’s been going on for just over 13 hours now, and there is no sign of it abating.

I fear this may be the proverbial final straw for me.  I don’t know if I can go on like this.  There are already so few motivations for me to continue living, and so many things that make life unpleasant.  I really don’t know what to do.

It’s slightly interesting that the pitch in my left ear is almost identical to the pitch in my right ear, just perhaps an eighth of a step lower.  I’m not sure what might be behind that fact.  Perhaps that’s the pitch range at which my cochleae are most vulnerable.  I am not really sure how I would find out.

It’s worth noting, though, that there is no internal evidence of any form of “beat” phenomenon such as would happen with real, external sounds that are close in pitch but not exactly the same, as their waveforms go back and forth between constructively and destructively interfering with each other.  This makes sense, of course; they are not real sounds but are neurological phenomena, and are occurring in opposite ears, and are thus initially processed in different sides of my brain.  The “beat” phenomenon in slightly dissonant pitches is a literal, physical, external phenomenon, not a neurological illusion.  This, at least, my current experience is making clear and convincing to me, at least provisionally.  I guess I knew it already, implicitly.  Has anyone else out there had this experience?

Anyway, as I said, if this bilateral tinnitus continues, I don’t know if I can.  It’s one thing after another, or rather, one thing on top of another.  Chronic pain, dysthymia/depression, insomnia, possible ASD, solitude, and now double-tinnitus.  My cup of hemlock runneth over, and maybe it’s time I just quaffed that motherfucker.

I guess I can give this a few days to see if it resolves.  I’m not optimistic.  Since the right ear tinnitus began, in the latter parts of the first decade of this millennium, it has waxed and waned in intensity, but it has not stopped for a moment.  But one instance of a phenomenon does not a pattern make, though my knowledge of the subject from a medical point of view gives me more data, and it’s not comforting.

I’ll take a break writing now, for the moment.  I’ll complete this post later.

***

Okay, well, I wrote 728 words on Extra Body, which was basically one single-spaced page.  I guess that’s good, considering the circumstances.  It’s nice when the office is quiet‒it’s quieter than the house is when no one is here, because at the house, except in deep winter, I have to have the AC and/or fan on or it becomes unreasonably hot.

I still don’t know what I’m going to do, though.  The ringing in both ears is constant, like that high-pitched noise they play that only young people are supposed to be able to hear.  I don’t even want to play guitar or anything, for fear of it interacting.

I guess I’ll see what happens.  I’m off this weekend; maybe the noise will abate.  Or maybe I’ll finally go fully mad, like the Master in response to the drumming sound in his head.  Which reminds me, the new Doctor Who “season” starts tomorrow.  I guess there is that to which to look forward.  I really like Ncuti Gatwa so far, so hopefully it’ll be nice.  I’m off work this weekend; my coworker will be back in the office today.

I hope you all have a good weekend.

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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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If you prick us, do we not blog?

Hello and good morning.  It’s Thursday again.  At least, I think it’s Thursday.  I’m fairly sure it’s Thursday.  I have on my Thursday trousers*, at least.

Yep, it’s Thursday; I checked my phone’s readout.  I was pretty sure anyway, but when my memory jibes with an external measure of which I have no current reason to be suspicious, that drives my credence even higher than it already was.  Most days I don’t need to double-check.  Most days, my internal experience of reality is persistent and consistent enough that I’m well aware of what day it is, usually even when I “first” wake up, to such a degree that if my smartphone’s readout gainsaid that, I would suspect that the phone was malfunctioning.

Today, though, I am mildly fuzzy-headed, relative to how I usually am.  I spent most of yesterday with some manner of persistent and non-peristaltic abdominal pain that left me very grumpy; it was good that I got started on payroll early and finished it early.

I didn’t leave the office early.  No, no.  I didn’t leave until nearly 7 pm, though it was different people who kept me late this time.

That’s part of the problem with things being so lax for my coworkers:  I have to be at the office first every morning (I do get there earlier than absolutely necessary, since I can’t sleep in the morning, anyway, and it’s better to travel before rush hour).  And I am also the last to leave at night, since I lock up the office.  Yet I live farther away than almost everyone else who works there, and I don’t drive.  So I am subject to the vagaries of each day’s least time-sensitive person, whoever it might be on any given day.  Often, the people who stay late do not arrive on time in the morning.  They are often also the people who work into and sometimes through lunch.

I ought to find a way to punish these people.  I ought to take extreme vengeance upon them, “in this life or the next”.  But I probably will do no such thing.

Anyway, that’s that.  I’m a bit fuzzier than usual because I didn’t even start eating any dinner or winding down until 9 o’clock or so last night.  And here I am at the train station slightly less than eight hours later.  So, plainly I did not have a full night’s sleep‒but that never happens, anyway.

On to other matters.

I still don’t know what to do about my fiction writing.  Writing this blog every day increases the daily readership by a significant margin, such that, in the few weeks in which I was doing 2 days a week, there were only about two thirds as many visits per day that I posted.  But, of course, it’s not as though I reach very many people even on my best days.

I am probably wasting my time doing this, both in potentially boosting the reach of my fiction, and in trying to improve my mental health by talking about it (there’s no sign of that making any difference, is there?).

I don’t know.  I suspect that if I suddenly just stopped writing this blog, there are only maybe two people in the world who would notice quickly, and they are both family members.  A few others might eventually vaguely realize that they were no longer getting posts from that weird guy who has insomnia and depression and goes on and on and on about it all the time.  Perhaps they’d wonder whether I just stopped blogging, or if I died, and if so, whether that was due to accident or illness or suicide

Actually, it’s reasonable in many‒perhaps most‒cases to call suicide a death due to illness.  It’s just a kind of illness that hasn’t been recognized as such throughout most of history, and still is not met with the attitude that would be useful from most people who interact with its sufferers.  Of course, it isn’t caused by any virus or bacteria (as far as we know) and so is not contagious in any straightforward sense (though memetic contagion cannot be ruled out in all cases).

Then again, people have only known about the contagious nature of things like smallpox and typhoid fever and the black death and the flu and various other infectious and parasitic diseases for a very short time.  But those are the comparative low-hanging fruit of illnesses, prevention and treatment-wise.  When a disease is caused by a definitive pathogen, an invader, there is a target that can be eliminated, if possible, to the unmitigated benefit of the one invaded.  It was a clear and definitive good for people when, for instance, smallpox was eradicated.

Problems related to malfunction or dysfunction or conflicting function of the organism itself, on the other hand, are much trickier.  The structure and function of a biological organism is akin to a vast and vastly complicated Rube Goldberg machine, where interventions in one region can have hard-to-predict effects elsewhere.  And, of course, once we’ve eliminated or at least significantly curtailed all the “easier” targets, then only harder ones remain.

Then people will complain about the slow pace of medical progress and the fact that some people must take lifelong medications to treat things like diabetes and high blood pressure, imagining that this fact is only and entirely due to, say, profiteering on the part of pharmaceutical companies.  Meanwhile, some of them will actually complain about and even resist the use of such things as vaccines, which have given them the luxury of being able to worry about things other than, say, how many of their children will die of measles encephalitis or will be crippled by polio.

It’s enough to make one want to paraphrase Colonel Jessup from A Few Good Men, and remind people that they rise and sleep under the blanket of the health and longevity provided by medical science and then question the manner in which it has been provided**.

I don’t know how I got onto that tangent.  Neither do I know why I got onto that tangent.  It’s all pointless, anyway.  I hope this hasn’t been too disjointed a blog post.  I also hope that you all have a good day, and a good rest of the week, and a good upcoming month, and a good rest of the year, and a good rest of your lives, and a good rest of eternity.

As for me, I’d be pleased just to get a good rest.  But I don’t expect that to happen any time before I die.

TTFN

*Yes, I have a pair that I wear specifically and only on Thursdays.

**But they don’t question it in any honest, serious, intellectual sense, such as would entail actually studying and deeply understanding even basic undergraduate level biology (to pick up a  weapon and stand a post, so to speak).  It’s remarkable how many problems seem so simple to those who don’t really, actually know Jack Shit about them.

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Top o’ the workweek to ye.

It’s Monday, and I’m writing this blog post at the train station after having walked here from the house.  I did a bit of working up to the trek over the weekend, walking about four miles wearing my boots on Saturday (and getting a modest sunburn in the process), then a shorter distance yesterday, wearing lighter shoes, all to try to counteract some possible deconditioning.  It seems to have worked at least to some extent, because I was able to walk the whole way this morning without stopping to rest.

Of course, it’s possible, in principle, that my preparations over the weekend were of no help whatsoever.  It’s even possible (in principle) that I would have found it easier to walk this morning if I had not prepared at all.  However, given what I know about the nature of adaptive physiology in humans (and humanoid creatures like me), I give both of those possibilities fairly low credence.

I downloaded the MS Word app onto my smartphone over the weekend, hoping that thereby I will make it easier to work on my fiction even if I don’t bring my laptop computer with me.  The app is linked to my OneDrive account, as is the program on my computer, so I can use the phone to write and update not just Extra Body but also, if I so choose, Outlaw’s Mind or even The Dark Fairy and the Desperado.  I think no one is interested in having me work on either of those stories (possibly ever again), but please, correct me if I’m wrong.

I am considering changing my blogging pattern, especially if I can keep up my regimen of walking to (and also, at least part of the time, from) the train station.  I plan to cut back on the blogging to Tuesdays, Thursdays, and on the Saturdays on which I work, which will be every other Saturday.  That way, I’ll keep getting at least some new fiction writing done three days a week.  Thursday and Friday (also Wednesday, if I recall) of last week, I got no work done on my new short story once I’d written my extremely gloomy blog posts.

Much of this, like other plans, depends on me getting a minimally tolerable amount of sleep.  My sleep was still fragmented quite a lot this weekend, but I took two Benadryl tablets on Friday night and one and a half on Saturday night, so I slept relatively well, at least for me.  The Benadryl has unpleasant ill-effects on my ability to concentrate, so I took none last night.

Interestingly enough (to me, anyway) the time adjustment this weekend was somewhat useful.  When I started waking up on Sunday, quite early even after the Benadryl, I looked at the computer clock and thought that, well, at least I wasn’t waking up too early.  Of course then I looked at the microwave clock and realized that it was “spring forward”* time, and I was waking up really quite early for a Sunday, especially after 1.5 Benadryl.

Still, given the shifted time, that particular “early” isn’t quite as early relative to everyone else as it might have otherwise been.  I still started waking up well before my intended time to get up this morning, but not as much before it as it would have been before the “time change”.

I’m hoping that the walking and such will help me be prone to rest (or supine to rest depending on how I lie down, ha ha) a little better.  I think a lot of what prevents me from being able to do what I mean to do a lot of the time is my lack of sleep.  If I can manage to improve that, things may seem better.

I remember, when I was young and even more foolish than I am now, I used to wish I didn’t need to sleep, or at least not to sleep much, envying the people I’d heard of‒truthfully or not‒who didn’t need to sleep as much as others.  I didn’t quite recognize that I was already beginning to be that way, myself.  After a certain age, I was almost always the first person to get up in the morning at home, and even when my friends and I would stay up very late, I was almost always the first of us to awaken.

Sleep doesn’t actually feel enjoyable or even pleasant to me.  It’s not something to which I look forward; there’s no reward sensation associated with it, and if anything it is filled with stress and tension, partly my dread of how early I’ll awaken and how tired (but not sleepy) I’ll feel when I wake up.

I know there are people who really like and enjoy sleep.  I am not one of them.  I simply become tired, and that’s unpleasant, and so I go to bed and go to sleep, and eventually start to wake up, usually not feeling good, not feeling rested, but feeling perhaps a bit less tired than I had‒though not always.

The only time I ever enjoyed the prospect of going to sleep and felt good going to sleep was when I was on Paxil for depression.  Unfortunately, that came with a host of side effects that made it not a great answer for me and my depression.  But it was interesting to have the subjective experience of looking forward to sleep and really feeling good about the prospect.  Weird, isn’t it?

All right, that’s enough for now.  I’ll write another post tomorrow, and hopefully I’ll have had a tolerable amount of rest and so won’t be too depressed.  Then, maybe, Wednesday I’ll just write fiction.  I guess we’ll see.

*It’s annoying that the new paradigm for “Daylight Savings Time” is set to have the jump back forward so early, because now the mnemonic “spring forward, fall back” is technically inaccurate, because it’s not spring yet for more another week and a half.  If they’re going to squeeze the time change in so close together, why don’t they just get rid of it completely?  It doesn’t actually change time, after all.  Within any given inertial reference frame, time is conserved; gaining an hour now entails losing an hour later.

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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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Did you know that the official name for February 15th is “Chafing Day”? Now you know.

Hello and good morning.  It’s Thursday, and I’m writing this post on my laptop computer, but I’m already at the office.  I really didn’t feel well when I finally gave up and got up this morning, and I was sorely tempted not to come to work.  So, I forced myself to come in very early—at personal expense—since I didn’t want to leave things hanging for other people at the office.  I hereby send out a “you’re welcome” to those people whose day I will be making slightly easier by my choice.

Yesterday was Valentine’s Day, though I didn’t mention it in my post, since it’s a day with little personal relevance to me.  Now, it’s the day after Valentine’s Day, which as far as I know has no “official” name.

In the UK and, I believe, in the rest of “the Commonwealth”, the day after Christmas is known as Boxing Day.  I have been unable to locate a reliable explanation of that term, but I personally imagine it referring to collecting all the boxes and other discarded packages that are a consequence of Christmas gift-giving.

I therefore now hereby propose that we all call the day after Valentine’s Day “Chafing Day”, because it’s mildly humorous, at least to me, and for some people it may even be accurate.  I doubt it will catch on, but maybe I can post a “tweet” or a Facebook message saying “Happy Chafing Day” to everyone, and see if the idea spreads.  Maybe I’ll title this blog post “Happy Chafing Day!” or similar, just to try to encourage the term.

If I’ve elected to do so, you readers will already know.

I felt pretty low at work, yesterday—even for me, I mean.  I told my coworker, the one with whom I’m closest, that I didn’t think I could keep doing this much longer, that I felt like I was going to hit the skids soon.  He misunderstood me at first, saying that he would miss me if I left for another job, but that I needed to do what I needed to do.  I clarified that I didn’t mean that I was thinking I would need to leave the job, but that I would need to leave—period.  By which I meant “to leave reality”, “to leave the world”, however you prefer to euphemize it.

He expressed his concern and said that he didn’t like to hear me talking that way, but of course, he had plans for the evening with his wife, and I didn’t feel like burdening him too much, so I put on a comparatively cheerful face afterwards.  Weirdly, I felt mildly relieved and more relaxed after that.

People seem not to take such expressions of emotional rock bottom as seriously as they might, but having at least gotten some word of my distress out to someone—other than regular readers of this blog—is something of a minor relief.  That way, if I go through the final exit door relatively soon, it will not be a complete surprise to everyone at the office.

I can’t keep feeling responsible for not causing inconvenience to other people at the expense of my ongoing misery, especially since so few people seem to return the favor.  My relationship with reality is an abusive one, and since reality is unlikely to change, I probably should just get out.

Another coworker, with the best of intentions, gave out some candy to everyone in the office, which was certainly a nice gesture.  However, being the weak-willed fool that I am, I ate mine, and then, after finally leaving the office quite a bit later than our supposed closing time—see my comment above about other people not being worried about inconveniencing their coworkers—I got some junk food on the way back to the house, and I ate it last night.

It was not very satisfying, and it probably contributed strongly to my ill-feeling this morning.  I need to take that as relevant feedback from reality and just avoid all such things from now on.  Snacks used to give me one of my only reliable sources of pleasure, or at least distraction, from the discomfort of life, but even they seem to be losing their power, though their costs are not likewise diminishing.  Today, I mean to put up a sign above my desk reminding others not to offer nor for me to accept such well-meaning “treats” in the future.

This situation is another example of the simple but hard-to-swallow fact that good intentions are not anything like a guarantee of good outcomes.

Often, once a person is secure in their good intentions—and I am provisionally convinced that most people who do such things really do mean well—they cease to assess the likely consequences of their actions.  If they mean well, they presumably think that they cannot do harm.  This, unfortunately but  clearly, is not the case, as anyone who has ever paid any attention to the nature of reality in any serious way will know—which is not very many people, I fear.

So, anyway, I’m physically tired and mentally tired, and I don’t feel well at all in either sense, either; I feel ill, both physically and mentally.  Alas, I have no reason to suspect there is any cure, though for certain aspects of things there may at least be some treatments, even if they are only palliative.

I told another coworker—one who is difficult but without meaning to be, because of his own life-long issues—that I more than half-wished I would get cancer, and that if I did I would not wish to be treated other than with palliative medicine to control pain.  Why would I want to prolong my life?  I’ve been undead for years already, and it’s not pleasant, and I see no reason to think that anything good will come along to change that.

It’s physically possible, in principle, of course.  I’m not so foolishly and superstitiously fatalistic to think that it’s utterly outside the realm of chance for my life to turn around and get better and remain better.  But as far as I can tell, the odds are very low.

I’ve waited things out for a long time, nevertheless, not wishing to be rash in drawing conclusions.  But if one is going to venture the capital of one’s continued time and discomfort and despair on some possible future upturn, one wants odds that justify the investment.  I don’t see any routes that carry such odds.  I have looked, and looked very hard, for them.  That doesn’t guarantee there aren’t some that I’ve missed, of course, but I’m not a stupid or unimaginative person—not in that sense, anyway—and I can only work with what I have and what I am, paltry though such resources may be.

So, anyway, I hope you all had as happy a Valentine’s Day as you could, and that you have a good Chafing Day today.  Spread the word about that title, if you like it.  Make memes and videos about it if you feel so inclined.  It wouldn’t exactly be legacy for the ages, for me, but it would be amusing, nevertheless.

TTFN

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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.

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How many times must a man wake up before he can sleep through the night?

What a terrible, horrible, no good, very bad sleep I had last night*.  I have said before, and I will repeat it in all honesty here:  my last good night’s sleep that I can recall happened in the mid-1990s.  So, I never seen to get a very good night’s sleep anymore, and this either contributes to or is a consequence of my dysthymia and apparent “neurodivergence”**.

Last night, however, was a bit of an outlier even for me.  For much of the night I would drop off to sleep and then awaken in stress, wondering what the time was and if I had overslept, only to discover that it was a mere five minutes since I had last looked at the clock.  I don’t know how often that happened, but we can work out the theoretical maximum just by taking the number of hours between when I first dropped off and when I finally gave up and got up, and multiplying that by the number of five-minute intervals (a rough but reasonably accurate average) per hour, which is twelve.

Given this, there was a theoretical maximum of between sixty and sixty-six awakenings during the night.  I’m sure I had quite a bit fewer than that, though.  for instance, I had a period of relatively long sleep during the early night, lasting about an hour to an hour and a half.  So, there were no more than 48 awakenings, and still probably significantly fewer than that.  Misery tends to amplify and magnify the subjective impression of these kinds of occurrences.  It’s probably a perverse version of the peak-end rule, described by Fredrickson and  Kahneman, which was used in colonoscopies before the general practice of doing conscious sedation, which ensures that people don’t tend to remember what happens during the actual test.

As one who has been present when colonoscopies were performed, I can tell you that patients are often semi-awake and even somewhat responsive to interactions during the test, but they do not remember it.  Such conscious sedation can give one the appearance of rest, but it doesn’t actually allow for effective sleep, though one may feel that one has slept during that time.  It’s also not the sort of thing to use outside of careful clinical monitoring, as the death of Michael Jackson demonstrated.

Anyway, I had a moment‒subjectively‒of relatively deep sleep quite early in the night followed by a very prolonged period of miserable and stress-filled, anxiety-ridden sleep throughout the remaining hours, until I gave up and got showered and dressed and ready and came to the train station quite early for the train.  That’s where I am now.

It’s not too cold here, but the wind is relatively strong, making it feel colder, and so I have my hood up.  I imagine I look a bit like a poor man’s Ringwraith from a distance, dressed all in back as I always am.  Or maybe I seem to be a would-be Sith Lord.  Neither is a pleasant state in which to be, of course, but at least they have powers.  My powers, if that’s the right word, are mainly just mental abilities, and unfortunately, my best ones are not really put to much use, other than in this blog.

I’m so tired all the time.  Nothing is very much fun anymore, as Pink Floyd sang in One of My Turns, from The Wall, disc one, side B, fourth song from the end.  Don’t Leave Me Now*** has already become an obsolete, already-too-late situation for me, which leaves only Another Brick in the Wall Part 3, and then Goodbye Cruel World to finish up the first half of that album.

I did get some new reading glasses yesterday, somewhat stronger than the previous ones, and I’m pleased to relate that they seem to allow me to read a normal, printed page (without adjustable type size) adequately.  I even read three or four pages of Quantum Field Theory, As Simply As Possible yesterday, and maybe that will be the beginning of something more.  Right now, I probably wouldn’t read it even if I had it in front of me.  But hopefully, with that one barrier reduced, the vector sum of that system in phase space will change, and I’ll do some more reading.

This leads me to wonder if it might be better if I overshot the vision target and got reading glasses that are stronger than the ones I have now.  Maybe I should try that experiment.  Thankfully, reading glasses are pretty cheap, so even if it didn’t work, I wouldn’t be out too much money.

Perhaps I would even rekindle (no pun intended) my ability to read and enjoy print books of various kinds if I did that.  It’s probably a lot to ask or expect, let alone hope for, but it might be worth a try.  My life post-FSP is unrecognizable even to myself compared to the one before it.  I’ve said many times that I feel that I’m like a Nazgul, or some other mortal who keeps a “great ring”.  I have not died, but neither am I growing or obtaining new life; I’m merely continuing, until at least every breath is a weariness.  “…thin and stretched out, like butter scraped over too much bread,” indeed.

Anyway, that’s more than enough of that.  I mean the blog post, of course, but I also mean the other‒that drawn out, continued existence that has no true life to it.  I’m just weary, and I have no hope for anything good in my future.  I need to get to the end of that first disc.  I can see no real point in anything else; it’s all just trudging through an endless, primordial desert with no oases.

*Unfortunately, I don’t think that moving to Australia would make a difference, and they probably wouldn’t let me in the country, anyway.

**Most likely it’s a complex system that interacts with itself, with each aspect feeding back on the other, the sleep trouble exacerbating the depression and other issues, and those issues further worsening the sleep, until some relative dynamic equilibrium is reached.

***And I want to make it clear that I never did the abusive stuff mentioned by “Pink” in that song.  I am certainly an unpleasant person, but I never was one to put my spouse “through the shredder in front of my friends” let alone “to beat to a pulp on a Saturday night”.  If anything, being the recipient of such things would be more likely for me.  But even if she had been so inclined, my ex-wife was not capable of beating me to a pulp.  Not that she would have been so inclined, anyway.  Though I suspect that most people who spend very much time with me entertain that notion at least occasionally.  Goodness knows I do.