Pain

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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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Mad morning musings and “The End of All That Is”

It’s Wednesday morning again, and here I am, reverting to habit, writing a blog post (this time on my smartphone) because I frankly can’t seem to think of anything better to do with my time.

Well…I could sleep.  That would be a better use of my time.  Except I can’t sleep.  Even on weekends, the only way I get myself to sleep through the night is to take two Benadryl™ before I lie down.  But that’s not really effective, restorative sleep, and though I stay in “bed” later, I can tell the next day that I’m not really rested.  Or maybe that’s just residual effects of the antihistamine, I don’t know.

The best thing about when I was taking Paxil for my depression‒which didn’t work overall, and gave me bad side-effects‒was that it made me not just able to go to sleep at night, but to actually feel good going to bed and going to sleep, to enjoy the process.  I had never experienced that before, nor have I since.  But, as I said, there were other side-effects that made it quite bad.

Also, it made me gain weight, which would be particularly bad now, because I’m already heavier than I’ve ever been.  That’s what can happen when one’s only reliable pleasure comes from eating, and when one also eats as a sort of “stimming” and soothing thing to try to ease a constant sense of anhedonia and stress and dysphoria.  And it’s not as though I could simply “embrace” my body size, because it comes with worsening pain and other unpleasant consequences.

Unfortunately, I don’t get immediate worsening of pain when I eat.  It’s delayed.  If it were immediate, I would probably develop a habitual avoidance, and that would be great.  I try to remind myself, when my ankles and knees and back and hips are hurting a lot, that this is caused, at least partly, by eating too much, but that auto-suggestion doesn’t seem quite to work.

I’m pretty sure that I would eat less if I slept better.  Chronic sleep loss tends to affect one’s regulatory and stress hormones, and can stimulate appetite (especially for carbohydrates) in many people.  I appear to be one of these people.

I wonder if I could figure out a way to cause myself pain while eating‒maybe I could put a clothespin on the end of my pinky when I eat, every time I eat.  I don’t know if you all remember, but having a clothespin clamped on your fingernail hurts quite a lot, and hurts even more (albeit briefly) when you take it off and circulation returns*.

If I could arrange something like that to happen whenever I eat, that would be useful.  I did have a TENS unit that never helped my chronic pain, but some of its higher settings could be quite uncomfortable.  I suppose it might be useful to train myself, though it would require setting it up and activating it every time I ate.  Also, I’m almost sure that I threw it away in frustration because it didn’t work.

It would be really useful if I could somehow trigger nausea any time I ate, as in the style of aversion training seen in A Clockwork Orange.  I suppose I could try to force myself to eat eggplant with every meal…but no, I don’t think I could.  It’s very hard to force oneself to eat things that make one feel sick.  That’s the whole point of this line of thought.  I guess I could look for some syrup of ipecac.  I’ve never used that, but I think they used to use it to make people throw up if they’d eaten something poisonous or the like.  It might be worth a try.  I think I’ll send myself a reminder to look it up on Amazon.

The train just arrived.  I must say, Tri-Rail seems to have deteriorated slightly since changing their schedules, but maybe they’re just in the middle of making adjustments.  I try to give other people and organizations the benefit of the doubt when I can.  The Principle of Charity is one that I think would be very useful for society as a whole, or at least for humans:  the idea of trying to see what people say and do from the best possible light you can, instead of reflexively assuming the worst, of getting judgmental and self-righteous and assuming anything you find even slightly uncomfortable is a personal attack on you, precisely because you feel uncomfortable.

If I took that attitude, I could definitely see myself trying to destroy the world or even the universe, because a lot of reality bothers me a lot of the time.  Fortunately, I know that my feelings are my problem and my responsibility, not anyone else’s.

Not that I don’t fantasize about global and even universal destruction when I’m feeling particularly pan-antipathic.  I imagine working to perfect technology to adjust the course of asteroids.  I could even sneakily get government funding to do so, but then I could actually use the technology to steer near-Earth objects toward the Earth rather than away from it.  Some good asteroid hits might be extinction-level events, and a comet impact (of sufficient size) could wipe out nearly all life on Earth.

I say “nearly” because some microbes are remarkably resilient.

Of course, if one could study the possibility of vacuum decay‒causing, for instance, the cosmological constant or the Higgs Field to quantum tunnel to a lower energy level‒that would produce a wavefront process that would obliterate all forms of matter, a wavefront that would expand at the speed of light and wipe out everything.

Well…it wouldn’t literally wipe out everything, actually.  First off, it would leave behind whatever cosmos is entailed in the new Higgs (or other field) set-point.  And, of course, beyond our cosmic horizon, there are bits of reality that are moving away from us‒carried by the expansion of spacetime itself‒at faster than the speed of light.  So the vacuum decay wave would never reach them.  But it would obliterate everything in the observable universe, and that might be heartwarming enough.

Vacuum decay, though, may not even be a physical possibility‒it’s not a consensus prediction, though there are reasons to think it might be possible‒according to the best models we have of cosmic history, the Higgs field did settle out in a non-zero state after the electroweak era, and if inflationary cosmology is correct, then the “inflaton” field similarly decayed.

Still, we also have no idea how (or if) such a decay could be triggered.  There is no apparent risk of initiating it through highly energetic physics, because there are constant, extremely high energy processes happening in the cosmos, and everything we can see is all still there, as are we.

Oh, and contrary to the X-Men comics’ Phoenix/Dark Phoenix saga, unfortunately, a “neutron galaxy” would not be “The End of All That Is”.  If such a “neutron galaxy” were to “appear” in the middle of the Milky Way, that would be bad for us, though its effects would take a while, since even gravity doesn’t travel faster than the speed of light.  But effectively, a “neutron” galaxy would be no more cosmically devastating than a supermassive black hole with the mass of a hundred billion suns or so.  That’s a big black hole, bigger than any we’ve seen (and probably too big to be expected to exist at the current age of the cosmos), and as with any black hole, if you get too close it can be bad news**, but from a distance its effects would be no more harmful than an ordinary galaxy of equivalent mass.

Oh, well, I’ll have to keep brainstorming ways to destroy the world or humanity at least.  Maybe biology is the way to go‒it might be possible to genetically engineer something like the Blob or the Chicken Heart that Ate the World.  Or one could deliberately make an AI that has the terminal goal to turn everything into paperclips, not by accident but on purpose.  That would be humorously ironic.  Or one could just make an AI nanobot, Von Neumann probe-style thing that literally had the sole programming to replicate itself as much and as fast as possible, using every available resource.

I’ve written before about how such a thing could even instantiate a new kind of galaxy-level natural selection.

I wonder what would happen if I tried to crowd-source a project to end all life in the universe, maybe with a “GoFundMe” page…

Anyway, my station is coming up, so I’ll draw my insane musings to a close for now.  I don’t know if I’ll write anything tomorrow.

*Don’t worry, this was not something anyone else ever did to me.  This was something with which I experimented on myself, because while it was painful, it was quite fascinating that the pain got worse when I first took the clothespin off.

**Although, with one that big, you could probably traverse the event horizon without tidal forces killing you‒at least not just yet‒by spaghettification, so it might at least allow for some interesting final experiences.

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The undiscovered country from whose blog no traveler returns

Hello and good morning and all the rest of that stupid bullshit.

I’m writing a blog post today—obviously—which means I’m going in to the office today, which means that, unfortunately, I am still alive.  I cannot give you any good reasons for these facts.  They simply are the case.

There are explanations, of course, as there are for all things, but they entail nothing more than the mindless churning of physical and, at the next level biological, and, at the next level psychological forces that happen more or less on their own.  They carry a certain metaphorical inertia; to divert them requires a deliberate application of some manner of force.  But since they are not literal, straightforward cases of inertia, it’s not always easy to tell just what the proper application of what “forces” should be to cause them to change their direction into one which one might prefer.

I’m at the train station now, waiting for the 2nd train of the day.  I had a terrible day yesterday, pain-wise.  It let up ever-so-slightly in the afternoon to evening, thanks to lots of Aspirin and Tylenol and Icy-Hot and all that stuff, but it still felt as though I had recently tried to do some fairly serious acrobatics without stretching and had not only failed, but had fallen hard on barely-padded ground.  I still feel stiff and sore.  Also, the bases of my thumbs ache severely; for that reason, among others, I’m typing this on my laptop computer rather than my cell phone.

I don’t have much else to report, and I certainly have nothing positive to relay to you.  As my pain eased slightly yesterday, my mood improved slightly, but it was never very good, and it’s now nearly as low as it was yesterday morning.

I’m also a bit nauseated.  That’s probably partly because of the excessive use of analgesics over the last 24 hours, even beyond my ordinary intake.

I really feel horrible, and I don’t know what to do.  I feel no sense of any future other than one of stress and pain and further alienation, or alternatively, of being a burden to people I have no right to bother.  I wish, I wish I had the strength of will just to stop eating and waste away until I die.  That wouldn’t be so bad.  After a while without food, once one gets into deep ketosis, there is little or no real pain, just lassitude.  And I have lassitude anyway, so I don’t think it would be all that much worse.

But it’s very difficult just to say “no” to food when it is available; billions of years of evolution has sifted things so that not eating when food is available is quite difficult.  I’m probably going to have to find some other way.

I’ve looked into things like hemlock—it seems like it might be nice and “classical” to go the way of Socrates—but although some descriptions of his death involve acceptance and serenity and the like, it seems they are highly fictionalized, which should come as no surprise.  Apparently, actual death caused by hemlock poisoning is quite uncomfortable, and associated with nausea and cramping and neurological symptoms of various kinds that might lead one to seek “help”.

Likewise, unripe ackee fruit—which grows in abundance around the house in which I live—is associated with quite uncomfortable symptoms and is not even close to universally fatal.  And again, the urge to try to relieve one’s symptoms might lead to one aborting the whole project.

Of course, asphyxiation via inhaling pure nitrogen or pure helium (for instance) is actually quite benign, since it is not associated with any feeling of suffocation—especially if one has a non-rebreather mask, so one does not retain carbon dioxide, which is the actual source of the feeling of not being able to breathe, and is indeed the primary driver of respiration.  I have two non-rebreather masks, and tubing, and even a regulator valve, but though I ordered helium tanks, I couldn’t figure out how to hook up the party-type helium tank output valve with the tubing and respirator mask—so I let people use the helium for balloons.

Also, one really needs a decent space and privacy for something like that, and one needs to make sure one’s mask doesn’t slip as one loses consciousness.  If that happens, one could live but have hypoxemic brain injury.

I’ve looked into ordering nitrogen tanks, but you can’t just get them delivered already filled; you have to go to some welding supply place or similar to get the nitrogen, and it’s hard to cart a nitrogen tank around when one does not have a vehicle.  There are similar problems with liquid nitrogen.  You can order a crucible (or whatever the term is) in which to carry it from Amazon (as you can the gas tanks) but to get the liquid you need to go to restaurant supply places or medical supply places or similar.  And, again, it’s hard to carry such things around without a vehicle.

Of course, there’s always simple use of blades—the proverbial bare bodkin—but though I am not afraid of cutting myself, to cause life-threatening bleeding thereby is not easy, and it is also supremely messy, leaving behind a horrible spectacle for some poor slob to find.  It’s likewise not entirely reliable and requires privacy.  I could lay down in my shower with water running and do it, but then my “housemates” and the landlord would eventually have to deal with the situation—at the latest by the time I started smelling—and that would be inconsiderate and traumatic.

When I think of the people I’ve known in recent years who have died of overdoses of narcotics—usually heroin—I again find myself wishing I had a drug problem.  But I don’t like opiates, though I was prescribed them for a few years for my chronic pain.  They didn’t work as well as I would hope, and the side-effects were annoying and unpleasant.  Of course, a goodly dose of an opiate plus a goodly dose of a benzodiazepine has a goodly chance of shutting down one’s respiratory drive, but as with asphyxiation above, that can sometimes just lead to brain damage.

My brain is dysfunctional enough.

A good fall from a high building (or mountain or cliff or bridge) is pretty reliable, of course, if one can muster the courage to throw oneself off.  However, there aren’t very many buildings or similar near me that are aesthetically high enough, and I don’t really have access to any of them, anyway.  Also, again, it leads to one making a mess for innocent passersby, and I would rather not do that.

There’s always the prospect of just swimming out into the Atlantic, which is truly close at hand, until exhaustion leads inevitably to drowning.  There’s not much mess that way, and most of what there is might be cleaned up by ocean life.  If I were more comfortable in the water, that might be a good option, and I still do consider it.  But it requires real determination, and I am not all that strong a swimmer.  I mean, I’m a good enough swimmer to swim out far enough to drown, but there’s enough stupid animal fear built into this operating system that I worry I wouldn’t be able to force my way through it.

I really don’t know what to do, or what I should do.  I’m still brainstorming ideas.  Meanwhile, I’ve really got loads of physical pain…but the psychological pain is worse.  The former wears down and eradicates one’s resistance to the latter, and the latter makes it difficult to keep a useful attitude about the former.  And I have so much trouble sleeping.  I’m really very tired all the time.

TTFN

standing on ledge newer

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Yeah, yeah, whatever.

It’s early morning and I’m waiting at the train station again.

It’s also relatively cool out, and it looks like it’s going to be so for most of the rest of the week, if the forecast is correct.  I should probably have walked to the train today, but even though I woke up hours ago, I just didn’t feel up to walking.  Actually, I didn’t feel up to much of anything at all, and I still don’t.

I almost just stayed at the house today, even though it’s payroll day, because I didn’t want to get up and move.  I’m really feeling that each and every thing I do or can do is utterly pointless, even taken from the scale of an evanescent mammalian lifetime.

Our boss apparently intends for the office to be open on New Year’s Day, but I am not going to be there.  I think it’s bullshit to make people try to work after New Year’s Eve and also to expect to sell anything.  In past years on those occasions when we have worked on January 1st, we barely made any business, and a good percentage of it was canceled.

I have no interest, and I have no motivation, to do anything at all, and certainly not to come in to the office on New Year’s Day.  Other people had their three-day weekends last weekend, and their family holidays, and you can bet dollars to donuts that most of them will not be coming to work next Monday, anyway.

Of course, it’s not as though I have anything better to do with my time by staying at the house; that’s one of the reasons I’m going to the office today.  I have nothing better to do.

I have nothing.

I had been looking forward to the 60th Anniversary and the Christmas Doctor Who specials, but now they are done.  They were good, and I’m glad I watched them.  But the regular season isn’t starting until May, apparently, and I’m sorry, I can’t wait around for that.  Five months is way too long.

I am tempted not to go to the office the rest of this week, or next Monday…or ever again, really.  I’m tempted not to go anywhere ever again.  What’s the point?  There’s nothing to which I look forward.  Life is just a series of discomforts‒many of them not at all minor.

My whole body has been hurting more than usual lately, despite aspirin and Tylenol and naproxen and icy hot and a massager and ankle and knee braces.  My back, especially, has felt as if the spine is becoming completely disconnected at its base and I am about to split in half.  And I’m getting some new form of sacro-iliac/coccygeal inflammation/arthropathy, too, the source of which I do not know.

I wish I could go into a coma.  I wish I could simply sleep.  No more.  ‘Tis a consummation devoutly to be wished.

I’m tired, and I feel horrible (and horrifying, come to think of it).  I hate my life.  There’s no point to it, and it gives me very little in the way of positive things.  Even thinking of my kids‒the best part of my life, ever‒just makes me miss them.  Since yesterday morning, I feel that I’ve just been fighting back tears most of the time.  It’s pathetic and disgusting.

I really do often wish I had some kind of drug problem (other than OTC analgesics, ha ha), but even alcohol gets unpleasant really quickly.  I bought a few bottles of wine for the holiday weekend and ended up pouring out as much as I drank, or more.  It doesn’t even do a good job of blunting my anxiety and tension, let alone making me feel good.

I don’t really want to see 2024.  I have no optimism about the year, and if anything, I feel that more and more of the little, stupid aspects of my life are falling apart all the time.  I’m just a net detriment to the world‒not that it deserves anything better, but still, I don’t enjoy that fact and process, and I don’t want to keep feeling the guilt and shame of my life.

I don’t know what to do.  I’m useless, even to myself.  I hate this world, I hate the social and political state of things (see yesterday’s post), I hate my body for its chronic pain, and I hate myself above all else.

I think I’m pretty close to being done, here.  I hope you all are having a more pleasant holiday season/experience than I am.  Tomorrow is Thursday, so if I do a post, it will probably be in my old “traditional” format.  If I don’t, you’ll know that I decided not to go in to work.  If I don’t ever do any more posts, I guess that will become evident after a while.  Though, of course, as with the halting problem in computation, you could never truly know that I was never ever going to release another blog post until you had waited until the end of time.

You could pretty sure, though‒sure enough to bet your life on, after not very long.  You could even bet my life, but that’s not worth much, so it’s not much of a bet.  It’s also a bit too self-referential and potentially paradoxical, given the subject matter.

Anyway, I’m sorry.  I know this isn’t pleasant, and you all deserve better.  But, it’s in my nature to disappoint and to bring people down, so that’s what I’m doing.  Have a good day if you can, nevertheless.

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I’ll rack thee with old cramps, fill all thy bones with aches, make thee roar that beasts shall tremble at thy blog.

Hello and good morning.

It’s Thursday again, and I’m writing one of my old “Thursday-style” blog posts, or at least I’m trying to do that.  I’m not sure how well it’ll come out, since I’m feeling rather poorly right now, but that’s mainly pain-related.

Yesterday afternoon, I had a brief respite from pain, or at least a significant reduction in it.  It got to the point where my spirits rose, and I joked a bit with coworkers, that sort of thing.  Nothing major, of course, but in the morning I had been thoroughly anti-social, wanting to snap on everyone from my boss to the few particularly irritating people in the office.  One of these latter had the gall to pat me on the shoulder from behind—while I was working on something—and I snarled at him not to touch me.

Mind you, that’s not new; I feel very awkward about people touching me, especially when they’re being irritating yet are trying to display some kind of manufactured camaraderie, and I’m trying to work on something important at my desk.  Also, this person had arrived late, as he frequently does, yet suffered not so much as a rebuke, and even got paid his “spiff” which is supposed to be forfeited when someone is late with good excuse.

As he walked away, I grumbled, “I’ll cut your fucking hand off.”  At the time, I meant it, but I’m not sure he heard.  Apparently, I don’t have a good sense of how to speak up so that people can hear me, even though I feel like I’m speaking just fine.

Anyway, in the afternoon I had less pain than usual, for unclear reasons, and that was good.  As I walked to the train station after work, it was cloudy and a bit drizzly and windy, but far from being displeased, I felt almost as if someone somewhere had decided to give me weather that felt at least a bit autumnal—which it did—as if in response to my blog post yesterday.  It was quite nice.  And I started thinking about getting back into long walking, and maybe some hiking and whatnot.  I was absurdly optimistic for a brief time.

I even brought my little laptop with me when I left the office.  That’s what I’m using to write this.

Overnight, however, my pain has resurged with a vengeance.  First my low back and down my left hip and knee and calf and thigh and foot and ankle flared up, waking me in the night, and I applied my little massage gun as best I could—after taking some analgesics, of course.  I soothed it enough to go back to sleep, but shortly thereafter woke up with my right side doing the same thing.  Now they’re both acting up, and it’s hard to stand up from a seated position because both of my hips hurt a lot when I do.  I’ve tried all along to exercise and stretch and adjust, and to do all the other interventions I can bring to mind, all the time, over and over, but it’s difficult to tell what, if anything, makes a difference.

I don’t know what led to my brief lull of pain yesterday afternoon.  I don’t know what made it act up again last night and through to now.  I don’t know if weather changes affect it, I don’t know if that’s just a bias or a random, illusory correlation.  I try very hard to be objective, but I can’t figure out what to do.

Of course, my hands—especially my thumbs—and my shoulders and my neck are also sore and stiff, but compared to the chronic pain in the entire lower half of my body, they’re almost pleasant by comparison.

I’m sorry to keep boring you all with this.  I would love to discuss something interesting and likely to incite wonder or at least curiosity.  But evolution has shaped pain to be difficult to ignore, unfortunately.  If you find it tedious and irritating, just imagine how it is for me.  You already have preemptive revenge upon me, for I have to live with it, and can’t even walk away to get a break, at least not in any predictable fashion.  Right now, on both sides, my entire body from about umbilicus level or so on down is one contiguous, 7 out of 10 ache, and my hands and my shoulders are stiff and sore.  And I can’t take anything else in the way of meds at the moment without it being frankly toxic, and also probably making me want to throw up again.

I have had various epidurals and other more invasive interventions in the past—including surgery, as you may recall—and yet here I am.  I have no desire to be put on prescription pain medicine again.  I’ve been through that, and I think the way it affected my thought processes didn’t help with the whole crash and burn through which my career and my life have gone.

The weather is so hot that it’s hard to deal with going for walks because I get so sweaty, but maybe what I really should do is just do what I’ve so often thought of doing:  go out and start walking, and keep walking (with rests as necessary) until it kills me or until I feel better—or both, I suppose, that’s not out of the realm of possibility.  I really don’t know what to do.  But, of course, I’m still doing this blog post, so I haven’t headed off into the sunrise yet, and right now, the process of even walking to the bus stop is daunting.

I may order a Lyft to get to the train station, or an Uber, whichever is cheaper.  I hate to waste the money, but I haven’t the energy to do other things.  By now, I could have bought an electric-assist bike or one of those electric scooters, and it probably wouldn’t have been much more expensive than car services.

I honestly and strongly hope that every last one of the people reading this feels much better than I do right now.  That would at least be some consolation for me, and not a small consolation at that.  I want you to have good lives and be happy, and to have friends and family around you, and to live among people who make at least a modicum of sense to you.  I hope you don’t feel like aliens in your own environments.

It doesn’t feel like too much to ask.  Maybe it is.  Anyway, I’m done with the blog post today, but there will very likely be one tomorrow.  Why would I stop rolling this boulder, after all?

TTFN

skelington

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There is no receding, you are pain. Something like that.

I’ve been trying, over the past few days, to write blog posts that are slightly more upbeat, and maybe a bit funny here and there, compared to most of my other posts.  I’ve done this to try to give a bit of a break to the people who read my blog with some regularity, and I hope the most recent posts have actually been enjoyable for them.  I’m quite sure they deserve to have something fun to read.

I don’t know if I’m going to be able to keep that up for long, or very consistently.  I’m afraid the increased pain I’ve had lately doesn’t seem to be abating.

Every night, pretty much all night, it’s been just gnawing away at my back and hips and knees and ankles like a demonic, semi-ethereal rat that can’t not gnaw because its teeth are always growing, and if it doesn’t wear them down, it will die a rather slow and horrible death.  If my pain were caused by some dreadful, progressive illness, I would surely be long dead by now, and that would likely be a mercy, for me and for the world at large.

I’m not just sitting back and letting it happen, just so you know.  I am always trying different stretches and exercises and combinations of analgesics and ointments and so on.  I also have massage gun thingies and a foot massager and a foldout massage chair at the office to try to help relax my back and feet.  I’ve tried inversion tables.  And I try to adjust various things to improve my sleep at night, and my sleep posture, changing pillows and locations and types of bedding and all.  Believe me, I don’t relish being in pain.

Speaking of relish, I even try adjusting what foods I eat, and when, to see if that makes any difference.  That’s a bit of a ham-handed* segue, I know, but it’s true.

Unfortunately, it’s hard for me to tell if any of it makes any difference at all.  For all I know, my chronic and daily pain might be no worse if I had never taken anything for it at all nor tried in any way to combat it.  My moments of temporary respite might be happening on their own, or due to my expectations, rather than thanks to any intervention.  It’s so difficult to judge these things with trials on one person involving a process that waxes and wanes in what amounts to a very long-period, low-frequency throbbing, but never quite goes away.

Even when I was taking chronic, prescription pain meds, the pain didn’t go away for long at a time, and the meds ended up causing suppression of my TSH and GnRH, so I had secondary hypothyroidism and low testosterone, which didn’t help my mood and health.  Certainly, weaning myself off of them didn’t make my pain worse, overall.  And as a bonus, my eyebrows grew back at their outer edges, where they had stopped growing when my thyroid was low.

There are some problems that we do not have the technology and science and resources to be able to solve or correct, and for which we may never have these things.  Perhaps it would be necessary for me to grow a new, cloned body in which to transplant my brain to cure my chronic pain.  Maybe even that wouldn’t work, because my central nervous system‒never quite ideally tuned anyway, though it has many fine features‒might have been too altered by chronic pain to do anything but induce it in a new body.  Maybe if I were a full on cyborg it would be better.  Or maybe it wouldn’t be.

There comes a time when fighting something is no longer beneficial, but is just an act of habit, or of ego, or of stubbornness, or some combination of these things.  My father died peacefully at home, with his wife and daughter (my mother and sister) nearby, taking medication to control his pain‒at that point, hypothalamic/pituitary suppression was not an issue‒and there are far worse ways to do things.  My mother was in hospice when she died, but my sister and I were nearby for her.

I’m sorry to say it, but when I die, I will probably die alone, and not merely in the sense that everyone dies alone.  Though I don’t like the idea of causing trouble for others, I fear that I will be one of those people who dies a solitary death in a lonely room and is only found sometime later.  It’s probably no more than I deserve, and no less.

Oh, by the way, I looked for that graffiti on the way back from work yesterday‒the one I mentioned that had briefly triggered a story idea but that I forgot afterwards.  I didn’t see it, though I tried to start looking at the graffiti as the train passed the spot where I remembered having seen it.  I saw lots of other graffiti that I remembered, but I didn’t see that one.  I’m pretty confident that I would have recognized it, though I suppose I cannot be completely certain.  I was in a slightly different position in the train car, so my angle might not have been right to catch the one I had seen the day before.  Oh, well, I did re-transfer my old notebook file of story ideas from my previous phone to this one, so I wasn’t otherwise idle.

That’s probably all futile, anyway.  I doubt that I’ll actually write any more fiction, or draw any more pictures, or write any more songs‒I probably won’t play and/or sing even any covers of any songs.  I’m just wishing when I think about things like that, just like I’m wishing for someone to be able to help me and to choose to do so.  Anyway, I don’t really deserve any help, so it’s not as though I expect it.

But boy, this pain is really getting old.  I mean, it’s been old for quite a while, and‒as they say‒it’s not getting any younger.  Neither am I, of course, and neither is anyone else.

I’m tired of being in pain, and I’m tired of being tired, and I’m tired of being alone.  I can try to do things about them, and I have done, and I am, though I may not necessarily mention all the things I do here in my blog.  But I do try.  I’ve been trying for a long time, and I will keep on trying for at least a bit more.  Like probably everything else in the universe, it’s almost certainly pointless, but it’s the way nature has programmed me.  I’m an idiot who doesn’t give up easily, even when he thinks it’s the sensible thing to do.

Maybe that’s why I make so many arguments about futility and pointlessness.  I’m certainly not trying to convince anyone else about life being pointless‒I would hate to think I had talked someone else into suicide**.  Maybe I’m trying just to convince myself.  Obviously, I haven’t succeeded yet; if I had, I wouldn’t be writing this.  But I am tired, and I am in rather nasty pain, and I am alone, and I don’t see readily available alternatives for the life I’m living, which I really don’t like.  I don’t have the energy to make any radical changes.  I barely have the energy to write this blog (and I can do that on my phone).

Oh, well.  The universe wasn’t made for my sake, and like everyone else, I wasn’t ever promised anything by the universe other than mortality.  It is what it is.  I don’t know if my existence is overall better or worse than that of an insect that’s accidentally wandered into an outdoor elevator car at a train station, and which will probably die in there, unable even to comprehend why it cannot seem to escape.  But I can’t be other than what I am.  Neither can anyone or anything else be other than what they are.

One thing I am is, “working tomorrow”.  So, barring the unforeseen, there will be a blog post forthcoming.  Who knows, maybe I’ll be able to report that I’ve figured out the solution to my pain and my depression and my insomnia and my disconnection and loneliness, and I’ll be able to share it with you and the rest of the world, and Earth will be transformed into a place of peace and joy for everyone.

I wouldn’t hold your breath, but I suppose that, technically, it is possible.  Have a good day.

*Ha ha.  There was no pun intended when I wrote that.  Honest.  I was actually quoting Hannibal Lecter…for whom food-based terms seem particularly appropriate, I guess.

**With the possible exception of some rare political figures.