mental health

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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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My poisonous (or poisoned) thoughts

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Digression within a discussion of digressions, and an ending about depression

I was a bit worried that I wouldn’t end up writing anything on my short story yesterday, because there were many distractions and frustrations.  I started the day in an unusually clear-headed and optimistic mood.  I even read a bit of Quantum Field Theory, As Simply As Possible in the morning, and that was nice.  But as the day went on and the chaos persisted‒especially the noise‒my optimism dwindled.

Then, in that latter part of the afternoon, I decided to force myself.  It’s just a single page, I thought, so it shouldn’t take long even if I do it between work tasks.  So, I got out the notebook and started up.  I used two different pens over the course of the approximate one and a half pages that I wrote, but write I did.

As I wrote, I could see again my tendency to digress into details perhaps just a bit much; I need to keep a weather eye on that tendency.

Don’t get me wrong‒I like getting into details, and into the minds of my characters.  Reading fiction and getting those insights into other people’s thought processes, even if they were fictional, really helped me in dealing with people as I grew up.  That’s a potentially useful hint: if you’re a replicant among humans, read a lot of fiction.  You can get whole lifetimes worth of insight into the their minds by doing so.  Indeed, you can get more than lifetimes worth of such insight, since in “real life” one never gets to see people’s thoughts unfiltered.

I’m not saying that fictional depictions are perfectly reliable and fully accurate representations of how humans think.  It’s fiction, after all.  But across genres and works, across authors living at widely disparate times, there are commonalities that one can pick up.

There may be selection bias at work as well, of course, since all works of fiction have been produced by fiction writers, and they may have common attributes not necessarily shared by those who do not write fiction.  But when findings from fiction correlate well with, and explain well, the behaviors and speech of people who are most assuredly not fiction writers, one can begin to assign higher credence to such things.

How on earth did I get into that train of subjects?  Oh, right, I was talking about my tendency to digress a bit in my fiction.  How very “meta” of me to digress even as I was writing about digression.

If I keep writing fiction‒assuming I don’t just die soon, which would also be tolerable‒I think I may adjust my guidelines during editing.

In my published works so far‒not counting this blog‒I made a rule that I needed to cut the final word count by at least 10% relative to the first draft.  That’s right:  Unanimity was one ninth again longer when I first wrote it!  Anyway, I may decide to set my target at a more draconian 15% level in the future.  20% seems as though it might entail too much cutting, but maybe 10% is too little.

I guess we’ll see.  Maybe I shouldn’t combine the effects of handwriting the first draft (which should encourage at least some brevity) and an increase in my culling target.  I guess I have time to ponder this matter and let my subconscious mind digest it.

In other news, I did play guitar a bit yesterday‒just those two songs I mentioned in yesterday’s post‒and I guess that was a bit of fun.  It seems my long breaks at least haven’t made me too rusty in my playing; I even feel that my intuitive feel for shifting between versions of  a chord while playing has improved.  I guess it’s possible.

I also walked most of the way back from the train station last night.  I didn’t make it quite all the way before summoning a ride, since I decided I didn’t want to push things too much, but it was a good walk of more than three miles.  I hope to increase it and add a walk to my mornings as well.  This will eat into my time, of course, and I worry about it discouraging my fiction writing.  I may go back to doing this blog less often in the future if I continue to feel able to write fiction and do get my walking going again.

I still have several moments during every day in which I think I just want to walk away from reality and existence, figuratively speaking.  The world can be horrifyingly frustrating and painful for me, and since I can’t convince myself that it would be okay to destroy the world, there’s always the option of destroying the universe (from my point of view) by destroying myself.

They call it “unaliving”* on YouTube, nowadays, apparently, because the YouTube algorithms are prone to block or interfere with videos that include the word “suicide”.  How stupid are these social media companies?  It’s ultramoronic to impair the use of a word simply because it refers to a real subject that is not necessarily comfortable.  The word “suicide” never magically induced anyone to kill him- or herself.  If anything, bringing it up can help take the taboo off and allow people who are suffering to feel that it may just be okay for them to talk about it.

Ha ha. Just kidding.  Nobody really wants you to talk about it, believe me, other than professionals who deal with the issues as part of their jobs, and rare volunteers, who are alas strangers, and who I suspect go into the work because of familiarity‒directly or indirectly‒with the problems of depression and suicide.  Most people just don’t want to deal with it.  I suspect that, secretly, many of them would prefer you to kill yourself rather than harsh their mellow.

Maybe destroying the world really would be morally appropriate.  At least I can do it in fiction if I want‒and I have done so, and have failed to do so, in more than one work.

Anyway, sorry about the regression to the mean (or at least to the unkind) there near the end.  I hope you all have a good day.

*”Unalive” sounds like it should be the opposite of “undead”.  So, if the undead are, in one sense or another, walking corpses, then the unalive should be inert living beings.  This sounds more like a description of those with major depression or chronic depression (dysthymia) than someone who has killed themselves, though the outcome of the former may certainly be the latter.  The euphemism is confusing and misleading, if you ask me.  The suppression of videos and the like that use the term “suicide” does not seem likely to decrease the rate of actual suicide, but may make a person contemplating it or troubled by thoughts of it feel even more alienated than they already do.  I know of at least one case where this is so.

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“Find my nest of salt”

It’s Friday, in case you didn’t already know, and since I am not scheduled to work tomorrow, it’s actually the last day of the workweek for me.  Oh frabjous day*.

I didn’t write a post yesterday, because I was out sick.  I think that some dip that I used had been in the fridge longer than I had remembered and had gone bad or summat, though it tasted okay.  Anyway, it certainly didn’t want to stay down after a while, so that was unpleasant.  I was worried that I might have caught some upper GI virus, but it was too self-limited an illness for that.

I feel as though I get sick on Thursdays more often than on other days, and especially on ones after a week in which I worked on Saturday.  I’m not sure if this is true pattern recognition on my part or some form of selection bias, but it feels as though it’s at least a slight trend.  I would suspect‒if it’s something real‒that it’s related to me getting worn down mentally (and physically) and becoming vulnerable to random physical insults after having had a longer week and no real recharge time.

This didn’t happen to me in the past, but then again, I was younger then**, and my reserves were deeper.  Also, I had a family to come home to, and a safe environment, and friends, and books that I wanted to read.  It was also reasonably quiet both at home and at school or work, and what noise there was‒even when it was quite chaotic‒was related to what was happening, what was being done, what the work entailed.

Things now are much different, and I need to find a way to recharge myself more rapidly and reliably, at least if I want to avoid total system collapse.  I’m not sure that I do want to avoid that, though.  Some part of me occasionally thinks that, at least if I completely fell apart, people would have to notice, and maybe someone would help me.

I doubt it.  The world is not set up well for doing very beneficial things, especially to and for people who are odd.  And I certainly don’t seem to be the sort of person people like to keep around for very long at a time, not in close personal contact, anyway.  They’ll happily‒or willingly, anyway‒keep themselves surrounded by shallow, lazy, manipulative users, as long as they wear at least a façade of warmth and cheerfulness.  But if someone approaches things differently, and is too mentally fatigued and fed up to bother trying to pretend otherwise or to force smiles all the time, they withdraw, even if that person works hard and tries hard, and is creative and smart and would never willingly betray them.

This is all hypothetical of course, but it does highlight why I think people‒indeed, the world‒are probably not worth keeping around.  Or it’s not worth keeping myself around to be among them.

Case in point:  for at least two days now (and it may have happened yesterday, too, for all I know) the Tri-Rail trains going north and south from my station boarded (with last-minute announcements) on opposite sides of the track from the ones they usually arrive on.  Now, it can make sense for one of the trains to board on its opposite side from usual; track maintenance needs to be done from time to time.  But having the trains switch sides smacks of someone just having screwed up, and then having done so again.  It’s not reassuring for passengers, that’s for certain.

Of course, my own reliability is not impressive lately.  I haven’t yet started work on HELIOS, though I have the blank notebook in my backpack (and another one remaining at the office).  I think, oddly enough, that if I were able to find a way to work on that during the day, I might recharge a bit just from that.  Then again, maybe I’m wrong.  I’ve only ever really successfully written fiction consistently early in the morning in near-silence.

Well, I haven’t given up on it yet, but I’m not optimistic.  I guess I’ll let you all know if I succeed in starting.

I also feel like I want to get the tabs to the Nirvana song All Apologies and learn it, and maybe do a recording of it, but I doubt that’s going to happen.  My guitars are just sitting unused.  Despite this, they give me no reproach‒guitars are very nonjudgmental that way.  They merely sit there, fallow, waiting and gathering dust, as is my keyboard (the musical one) and my cello.  It’s a shame, I know.  But, as the song’s lyrics say, “I’ll proceed from shame.”***

For now, though, I won’t proceed any further than this final paragraph.  I hope you who read this all have a good day and a good Saturday and a good Sunday if you’re at all able to do so.  As for everyone else, well, who cares about them?  They’re not like us, right?  We don’t need them.  They are our enemies, and we are theirs.  JK…OAI.

*Was anyone else really, really bothered when, in Tim Burton’s movie version of Alice in Wonderland, they referred to Christopher Lee’s character as if its name were “Jabberwocky” when that was just the title of the poem from which it was drawn.  The creature’s name, or title, is the Jabberwock.  It says so right in the second stanza of the poem:  “Beware the Jabberwock, my son!”  Yeah, I figured nobody else probably cared.

**Almost by definition.

***I don’t believe that the line is “aqua seafoam shame”, as so many people seem to think.  That’s merely a classic mondegreen.  I think this largely because the mondegreen version is a weird, abstract, bizarre bit of imagery that doesn’t resemble anything else in the words or tone of the song, whereas “I’ll proceed from shame,” follows quite logically from the preceding “I’ll take all the blame”.  Cobain’s lyrics could be cryptic and quasi-nonsensical sometimes, but their tone is more consistent than the whole aqua seafoam thing would be.  End rant.

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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.

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Monday’s blogger at least still likes to learn

Hurray, hurray.  It’s Monday.

It’s probably hard to tell from the printed words, there, but I was being sardonic with that opening pseudo-exclamation.  I’m not excited that it’s Monday and the beginning of a new work week.  Then again, I’m not excited by much of anything.  Staying at the house doesn’t seem likely to be exciting, either.  There’s not much I can think of doing or any place I can think of going that seems exciting.  Nearly all the things in the world are on some spectrum from boring to stressful.

I don’t recommend this as a way of being, not even to myself.  I’m trying to find ways around it, or rather, to counteract it, but all my previous attempts have not succeeded in any durable fashion, as should probably be obvious.  Various medications, various therapies, lifestyle changes, exercise‒none of it has worked.  Some time ago, I had some hopes that trying marijuana that a former friend had would at least help my pain, if not my depression, but it did neither after two tries, and when I tried too much when I was in particularly bad pain, it made me quite sick to my stomach.  I was throwing up for a few hours (not continuously, of course, but it was still pretty bad).

It’s ironic that THC is used to treat nausea in many cases.  Evidently, my nervous system is too atypical for such things.

I recently happened upon some videos about psilocybin, specifically that there’s a study beginning on using it to try to treat some of the negative symptoms of autism spectrum disorder.  I know it has been used to treat recalcitrant depression and related disorders, including depression in people facing terminal cancer.  Psychedelics have always sounded intriguing, and people make much of them, but I think, given my experiences with other meds, I would be very frightened to try any of them.  My mind is not my friend, and I worry that I would be particularly prone to a “bad trip”, and there’s no way to abort such a thing once it has started; one just has to go through it to the other end.

Speaking of being anxious and frightened of things that many people find beneficial, I had meant to retry riding my new bike yesterday, and perhaps to ride it to the train and then into the office today, but I find myself subtly terrified to do so.  The beginning of last week was just so exceptionally painful and horrible that I am frightened of reinitiating it.  I wish I could know that it’s something that would resolve after a time, but it seemed to worsen over the course of the three or four days I was riding, until by last Monday I was bed-ridden, and I was even grumpier and more cheerless than usual on Tuesday, if you can imagine such a thing.

I think I’ll have to forgo it.  My boss really liked the bike, and offered to buy it from me if I can’t use it, but then I need to get it up to the office, which would mean riding it.  I don’t see myself carrying it.

My train is coming in five minutes.  I’ll pause and then return to this once I get on the train.

***

Okay, I’m on the train now.  What was I talking about?  Oh, yeah, the bike.  I guess I could have it shipped up to the office.  I think Uber even provides services like that, or I could try to see if there’s a way to set up an Uber in a vehicle that can carry the bike.  It’s a thought.  I don’t see my boss making a trip all the way down to my place to pick it up.

I guess I should stick to walking, even though it’s slower.  At least I can listen to audiobooks and podcasts and such while walking.  Nothing beats The Fellowship of the Ring as walking accompaniment, since it’s all about a journey on foot.  Even walking has its troubles, of course‒I have spandex braces on my left knee and right ankle to address the little bit of walking I did yesterday, and the right side of my back is in moderate spasm.  But that sort of stuff is par for the course.  If/as I lose weight, some of that will decrease, and some of it may even disappear.

Life is annoying on so many levels.  But at least there are lots of videos on things like hyperbolic geometry and computers and tensors and matrices and Einstein’s field equations and things like that.  It’s often the case that if I find several different people explaining the same thing I end up with a much deeper understanding.  Each teacher or author or whatever approaches things in a slightly different way, with different emphasis.  When one sees a subject from multiple angles, one tends to get a more complete and thorough understanding of it.  In this, I guess it’s analogous to binocular vision, which gives us depth perception.

I really want to read Zee’s book on quantum field theory, but although these new glasses are better for such smallish print, I think maybe I should have gone even higher on the strength.  Maybe I’ll go to the drugstore over lunch and pick up a stronger pair.  It would get me a bit more exercise, at least.

Please don’t emulate or internalize my negative outlook on things; I have no desire to see a world where more people are depressed.  Do try to keep learning.  Try to build as accurate a map of the world‒in all senses‒as you can.  Be ruthless with yourself in that process.  Your biases will try to trick you, and they will never stop trying, so you need to apply active countermeasures against them.  It’s a pain, but it’s important (and often satisfying and even thrilling) to work toward as accurate a map as you can get, not one that shows a world the way you would like it to be or you believe it to be.  A poor map will be less likely to get you anywhere you might want to go.

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Audio blog for Friday on anhedonia, fatigue, declining entertainment franchises and Newtonian and Einsteinian physics

This is an oddly meandering audio blog that I made this morning, having little desire to write much, and it goes from my troubles with depression and lessening interest in any former source of joy to the fact that even Star Wars and Marvel franchises are going downhill (with speculation about the causes) on to physics–first Newtonian then Special and General Relativity, and ponderings about the nature of near-light-speed travel and its potential effects when a spaceship passes the Schwarzschild radius in the direction of its motion (and even a tiny dabble into cosmic strings, which are not to be mistaken for the “superstrings” of string theory/M theory).  I find no firm conclusions, but maybe it’s mildly interesting somewhere.  It’s longer than I expected it to be, but hopefully not too long.

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The title of this blog post is unrevealing

It’s Tuesday morning, and this is my first post of the week‒which I guess is not so bad, since a few weeks ago I had said I might not write any more at all.  I’m not sure why I am still writing, other than simply as a matter of habit, which tends to be strong with me.  Perhaps that really is the only reason.

I was not out “sick” yesterday in any traditional sense, but was instead out with a severe exacerbation of pain in a slightly unusual distribution: left foot, knee, and hip/iliosacral areas in addition to a bad flare up in my back.  Every kind of movement was painful for me, so I mainly just laid around taking aspirin and Aleve and Tylenol and trying to give my body a break.  It’s a bit better now, though by no means ideal.

I fear this pain was because of riding my new bike, even though I didn’t ride it very far or very long over the weekend, and it felt okay while I was riding it.  That latter bit is typical, though.  Things that trigger exacerbations often don’t do so right there at the moment.  They take time to build up and catch one by surprise, so one is never quite sure what the real cause of the flare-up is.

For instance, a cold front came in over the course of Sunday afternoon, and the temperature dropped by nearly thirty degrees (Fahrenheit) by Monday morning.  That brought it down to about 50, which is quite chilly for south Florida.  That may have contributed to the increased pain, but I’m pretty sure it wasn’t the main cause.

I did at least get a bit of rest yesterday, napping whenever I could, which is nice.  But I’m quite frustrated to get pain flare-ups from riding the bike.  It’s very discouraging.  I was hoping the bike would give me more freedom of movement, not less.

I did get to talk to my daughter on the phone on Sunday.  We’d been planning to talk for a few weeks but stuff kept getting in the way on her end, but finally she was able to call me yesterday.  It was very nice.  I hadn’t heard her voice in about 8 years or so, and it has changed, since she was a teenager the last time we spoke.  We had a nice conversation, at least for me.  She seemed to be enjoying herself, also, but one can never easily be sure, especially when someone is talking to me.

Also, I spoke to my sister last night, but it hasn’t been nearly as long since I last spoke to her‒about a week, in this case.  We had a nice conversation, though, as always.  As for everything else, well…there is nothing else, really.  I haven’t written any new fiction or played any music or drawn any pictures or anything else of value.

I’m taking an Uber to the office because it’s still pretty painful to move and I want to keep it to a minimum.  It’s also hard on the bases of my thumbs, writing this in the back seat using my smartphone, but I don’t know what else to do about that.

Honestly, I don’t know what to do about much of anything.  I’m still very much at a loss about life in general.  I still haven’t been able to bring myself to look into health insurance.  I don’t have any future plans, really.  I’m basically empty‒except for pain, obviously, but I already mentioned that.

I also have a lot of free-floating anger a lot of the time, I guess that’s something.  At least, it is if you like being angry.  I never really have enjoyed it, though; it makes me feel guilty, even if I don’t act on it.  It’s not pleasant.  Maybe I should learn to embrace it, and all that.  At least it’s slightly energizing, temporarily.

Oh, well.  It doesn’t matter, I guess.  I’m not sure that anything does matter.  I guess that’s all a matter of perspective, so to speak.

That’s it for today.  Try to have a good one, if you can.