Thoughts on chronic pain, modern medicine, alternative medicine, acupuncture, surgery, and anti-depressants

I started Lexapro a week ago. My primary care doc gave me a sample back in March, but I hate taking that kind of thing except as a last resort. On Tuesday, I thought that, well, it’s last resort time, so I looked Lexapro up on the net and learned that it’s for depression and anxiety in the worse-off of the worst-off. I’m not altogether catatonic, but close enough.

I can feel it raising that old familiar floor beneath my emotions that desipramine, Prozac, Wellbutrin, and Zoloft erected, only maybe higher and stronger. “And, lo, the Lord, Lowell’s God, looked upon that floor and saw that it was very good, and he sayeth unto Lowell, ‘Lo, Lowell, this floor, it is very good, but let us maketh it better by raising it higher, even until it is above thy head,’ and Lowell answereth the Lord, Lowell’s God, by saying, ‘Lo, Lord, the same floor cannot be both beneath my feet where it will doeth me good and above my head where it won’t, and the Lord, Lowell’s God, answereth back unto Lowell, ‘Lo, Lowell, all things are possible for the Lord, Lowell’s God,’ to which Lowell sayeth, ‘Oh.’ And the floor was raiseth, and Lowell fell out from under it.”

For most of my life, I had but one doc whom I rarely saw. This year, I’ve had one sleep specialist, three surgeons, two anesthesiologists, countless radiologists, two neurologists, one dermatologist, and one primary care physician. Today, I added a hand specialist (to help break down scar tissue from my carpal tunnel surgery) and an acupuncturist (for my back and shoulders) to my entourage of nurses, aides, phlebotomists, x-ray techs, massage therapists, physical therapists, and lab techs. One of the dominant labels that I now place upon myself is that of patient.

Medical doctors, are, by and large, less than pleasant people. They’re harried, impatient, unreachable except during paid visits, think of me as an assemblage of parts, don’t recognize me when they see me, and have offices that are brown and gray with nothing of solace or beauty except maybe a single print that looks to have been added as an afterthought.

My primary care doctor is somewhat the exception. His office is the worst of all, but he encourages me to talk about any and everything, and he listens good. He is also my only doctor who is not young enough to be my child. In fact, he is my exact age—fifty-nine. He’s a little more wrinkled than I, perhaps, and a lot more stooped. He also shuffles when he walks and has a tremor. You might say that he looks like hell. You might say that he looks like he should be my patient rather than I his, but maybe I flatter myself. In any event, I leave his office with the suspicion that I am better off with my problems than I would be with his.

Alternative practitioners are the opposite of regular doctors. Maybe it’s because they lack the scientific cachet, or maybe it’s because their patients are mostly people who are disenchanted with regular doctors, or maybe it’s just that they all happen to be supremely sensitive spiritual types. Whatever the reason, they are given to hemp clothing and to decorating their offices with Buddhas, waterfalls, potted plants, pastel paints, and rice paper prints—with meditative music in the background.

I go away from doctors’ offices disappointed that my “healer” had no interest in me except for a single joint or organ. When the acupuncturist I saw today tried to draw me out by saying, “You must be really frustrated by all this pain,” I immediately lowered the drawbridge and sent the archers to the castle walls. “What the the hell are you trying to do here?! I thought. “I’ve only known you for fifteen minutes. I’m not going to open up to you.” A while later he said he needed to leave the room for a moment, and I wondered, “Why are you leaving the room? Am I that hard to deal with? Don’t you like me?” It’s not that I’m impossible to please (no, not I), just that I’m ambivalent.

The acupuncturist is my last hope before surgery, so I read all I could about him and about acupuncture in general before I saw him. Almost every scientific study concludes: “Couldn’t come to a firm conclusion. More research needed.” Great. So, I questioned today’s acupuncturist as closely as I could without being obnoxious, and I couldn’t be sure, but I thought that maybe he didn’t like it. The truth is that nobody likes to be challenged. Even if they say they do, they don’t. Even if I try to be really, really tactful, they don’t.

He stuck needles into my lower arms, abdomen and feet. The pain in my right shoulder went from a two to a six (eight being about what it would take to bring tears). He noticed my discomfort, and put a pillow under my upper arm. “Does that help?” “Yes, I feel better now.” “Are you sure?” “Well, maybe you could lower it a little.” He did, and then stood looking at me in earnest silence. Next he put a pillow under my shoulder. “That’s even better,” I said. Then he put a second pillow under my head. “That’s better than when I came in!” I exuded. Night after night, I toss and turn in pain, yet it never occurred to me to use an extra pillow.

I hadn’t paid for moxibustion, but he did moxibustion. I hadn’t paid for magnets, but he put one on my neck and one on my right shoulder. Then he left me while these things did their magic, His potted ficus looked down upon me sympathetically, as if it too were a healer. But will magnets and needles and burning mugwort help? I divide treatments into things that make sense and will probably work, things that don’t make sense but might work anyway, and things that seem too stupid to even consider; and I’m open to the first two categories. Nothing Tom did seemed stupid.

The thing about medical doctors that bothers me most is that they are a lot more interested in treating symptoms than treating causes. In fact, they are often completely uninterested in causes. Maybe this is because they are expected to see several patients per hour. Or maybe it’s because symptoms are obvious, quantifiable, and approachable. Until three years ago, I was in pretty good shape. Then I had knee debridement so that I could hike twelve miles over steep terrain without a knee ache. Thanks to that very simple and very routine surgery, I can no longer walk more than a few blocks without pain, and I’ve gone downhill like a pig on a greased slide. If I were a doctor, I would be curious about that, but even my primary doc just kind of throws up his hands and grabs for his prescription pad. “Depressed about your declining health? How about a nice sample of Lexapro? It’ll do you good. Besides, Forest Pharmaceuticals often buys lunch for my staff and me—not that I would let it influence me any.”

Just as carpenters see every problem as requiring a hammer, surgeons call for a scalpel, so if you don’t want surgery, don’t go to a surgeon. That shoulder surgery (subacromial decompression, which translates into “take the pressure off the area beneath a bone called the acromium”) I cancelled two weeks ago has a four-month recovery period. In other words, the surgeon would injure me so severely that I would need four months, not to recover from the ailment, but from the treatment. Does that sound like anything YOU would jump into? Sure it’s a simple surgery (for the doctor), and sure it’s routine, but then my knee surgery was even more simple and more routine; and because of how IT turned out, I never lose sight of the fact that, if the worst happens, it’s not the doctor who will be screwed. What’s more, the doctor might not even care. Mine certainly didn’t want to be reminded of his failure.

Maybe my primary doctor is right about the brain. Maybe it’s all (or at least mostly) physiological—what goes on in there. It sure looks that way. A stroke, or a head injury, or a pill, can dramatically change a person. I’ve seen it from the inside. When I’m on an anti-depressant, all the dark thoughts that I had are still lurking in the shadows, and they still seem more real somehow than the positive thoughts, yet they have been robbed of their power. It’s as if I’m standing behind a bulletproof window, and can see the darkness coming at me, only it can’t penetrate the glass. Pills don’t make me into a flaming optimist; they just make me indifferent to sadness.

Unfortunately, it’s not just sad thoughts that bounce off the glass, it’s also my ability to be deeply touched by love, art, music, nature, innocence, heroism, and compassion. Poignancy becomes just another word in the dictionary that I can understand but can’t personally relate to. In short, to deaden what I hate about myself, the drug must also deaden what I love most, the two being somehow intertwined. That is why I don’t take the damn stuff unless I’m so screwed up that I become fixated on suicide. In the current circumstances, it’s not that I want to die; it’s that I want the pain to die. Unless you’ve been awakened time after time, night after night, by one of the worst pains you’ve ever had, you won’t know what I’m talking about. When the acupuncturist asked me to describe it, I said that it’s like someone stuck ice picks deep into both shoulders. If the pain were any worse, I would howl like a dog.

I’m reading a mediation book (break through pain by Shinzen Young) about the spiritual growth that is possible with chronic pain. He says that the pain is not the BIG problem; it’s the terror, the outrage, the refusal to accept the pain that’s the BIG problem. Yes, I can see that. Heads or tails. Suicide or saintliness.

I can’t hike because of my knee. Now I can’t bike because of my shoulders. I’ve never much cared for meditation, but at least meditation is something I CAN do. Maybe, for now, I need to accept that life is not NORMAL, and might not be normal for a long, long time, and that, just maybe, something good can come from that.

Sleeplessness

It’s a chilly Labor Day, too soon to start the furnace, but too cold to be comfortable without it. I am wearing both a sweater and a light jacket.

Two weeks ago, I postponed shoulder surgery, partly because I was afraid it either wouldn’t help or leave me worse off, partly because I dreaded the long recuperation (for the first ten weeks, my arm wouldn’t even be able to support its own weight), and partly because I wanted to give physical therapy another month or two. At the time, I showed little progress with therapy, and, to tell the truth, couldn’t actually say but what it was hurting more than it was helping. Since then, I’ve deteriorated greatly—a deep massage plus my reluctance to forego exercise seems to have triggered my decline—and now I don’t dare exercise at all.

Shoulder pain keeps me from sleeping on either side, and now my back is hurting me as much as my shoulders. Since my sleep apnea mask doesn’t allow me to sleep on my stomach, I’m challenged to get any sleep at all. An Ambien, plus an anti-inflammatory, plus Tylenol, plus heating pads and ice packs, enable me to sleep, at most, for a few hours before I awaken in pain. They also make me nauseous. Even if I went ahead and had the surgery, I would feel worse for weeks if not months before I felt better—and that on one side only—and I don’t see how I could bear it.

Of such problems as I have had, sleeplessness is the worst. To be so tired yet be unable to rest engenders a feeling very near panic. Just the thought of lying down fills me with dread although I can scarcely stay awake.

I suppose I will try a chiropractor and maybe an acupuncturist, although I can find little evidence to support them. But then the evidence for surgery is mixed too. My particular surgeon boasts of a 96% success rate (how would he know?), but the average seems to be more on the order of 80%.

I wish to god that I knew what to do. I am finding it hard to direct my actions from moment to moment much less to make major decisions.

Bears, Mountain Lions, and Surgery

The best times to go to the woods are in late spring and early summer when the most flowers are in bloom, and in mid to late summer when the berries are ripe. On our last trip, we dined on raspberries, dewberries, blackberries, thimbleberries, red huckleberries, salal, and even the strange tasting Oregon grape. My favorite, the lush orange salmonberry, was all gone, and I will grieve its loss until next summer. When we go to the woods again (we venture out once a week), we will take berrying buckets and stock our freezer.

The coast range has far more berries than the Cascades, and far more bears to show for it. On our last bike trip before Peggy’s mother died, an adult bear crossed the road 300 feet in front of us. As I grew abreast of the spot, a movement caught my eye, and I spied its cub frantically climbing a small tree no more than ten feet away. “Oh, look at the little baby bear,” I cooed to Peggy—who had not seen it. She made no response, and when I looked back at where she had been, she was disappearing down the mountain in a cloud of dust, and I was unable to catch up with her for quite some time. When I finally did, I said simply, “You were going for help, I suppose,” knowing full well that Peggy had considered it a case of every man, woman, and dog for itself—her being powerfully afraid of bears. My only terror is of mountain lions, and I worry mostly about our dogs because the question in my mind is not whether a mountain lion would eat them, but why wouldn’t a mountain lion eat them.

Peggy took a spill last weekend, and came away with some bruises and road burns. Logging roads are often paved with poorly packed rocks of uneven size, so it is not unusual for our wheels to be thrown several inches to the side. No one can bike in such places without an occasional wreck.

I am scheduled for rotator cuff surgery toward the end of the month. I can hardly sleep for fear, only fear is too weak a word. I try to calm myself by reciting poetry, but I can scarcely focus long enough to get through a single verse. My days are less terrible than my nights only because I can at least distract myself with work, even if I am so panicked that I make one stupid mistake after another. One might think that with all the surgeries I’ve had, I would handle myself better, but the reverse is true. Even when I have confidence in my surgeon, I have no confidence in my luck. It’s not that I consider myself unlucky, but that so much can go wrong, and so much of what can go wrong can never be made right. How many times have I wished I could have screamed “Don’t do it!” at myself as I walked to the hospital for knee surgery, even that short walk being longer than most of the ones I have made in the years since. My intention was to prolong my hiking years, not to end them altogether. Now I can but bike, and I won’t even be able to do that for four months after my next surgery. I won’t be allowed to so much as lift my arm for six weeks, and nothing more than my arm for another month.

Some might interpret my terror as a premonition, but I have little to no faith in premonitions. What I do have faith in is my ability to made prudent decisions, but no matter how prudent I try to be, there is always uncertainty, and there is always the possibility that I will learn something after the fact that would have led me to choose differently. Oddly enough, the more fearful I become, the harder it would be for me to back out of surgery in the absence of a really good reason to do so.

I have spent hours combing the Internet for alternative treatments, but the trouble with alternative treatments is that they are seldom supported by hard data. I can find study after study about surgery, but no studies whatsoever about Rolfing, Tragering, acupuncture, chiropractic, and so forth. If they could but offer me some reason to believe in them (other than their own authority and the anonymous testimonials of their patients), I would jump at the chance. Yes, medical doctors sometimes kill their patients whereas homoeopathists never do; and, yes, medical doctors are glorified parts’ technicians whereas alternative therapists treat the whole person. But I see no other option. I can have surgery now, or I can have surgery later. Or—as I’m told—I can have surgery now, and still have surgery later since an enlarged tendon can’t be reduced. The most that a surgeon can do is to remove some of the risk factors that might lead to a tear.

Friendship's End

(This entry contains slang sexual references.)

Mark and I got together a lot until we both moved to other parts of the country, and didn’t see one another for twenty-five years. What follows is the post mortem of our friendship, not that I am in a position--a month after it ended--to fully understand what happened, or to know if I might have done better.


I wrote:
You wrote that you seldom use your Frequent Flyer mileage. Maybe we could cut a deal.


Mark wrote:
Now when did you start needing somebody like me to foot your travel? Get online, find some rich ole horny woman to fly you wherever you want to go! You still throw down don’t you? That’s my plan when I get to be your age.


I wrote:
If I had something I didn’t want, and you did want it, I would either give it to you or sell it to you. Such is what I had in mind. Why would you throw something away rather than to let someone else have it?


Mark wrote:
I’m just busting your chops. I’m just trying to accumulate enough to get platinum status. That’s when the perks really kick in...


I wrote:
Busting my chops? Yes, the image of being hit in the mouth fits.

Several weeks ago, I suggested accompanying you on one of your foreign trips, if you would have time away from work for me. This was a significant way for me to reach out to you as I rarely leave the county much less the country. My image was of us having fun together while broadening our intellectual horizons and renewing our face-to-face friendship. Your response was to ask why should you want to go with me when you could go with your latest piece of ass.

I was reminded of the time I drove to Missouri to see a friend who had moved there from Mississippi. As it turned out, he had no time for me because he had a new honey. When I complained, he assured me that he liked me, but that, after all, why would he want to be with someone who looked like me when he could be with someone who looked like her.

I concluded that you are of the same mind, that a male friend is only of value as a diversion when you are between females. I gave up any thought of ever going out of my way to see you, and I questioned whether it was even worthwhile to write to someone who holds me—as a male—in so little esteem.

You wrote that you DIDN’T use your frequent flyer miles because they were too much hassle. Peggy and I go out of our way to accumulate such miles, and she, at least, uses them to visit her family. When I suggested that you either sell or give them to us, you implied that I’m a freeloader. When I asked why you preferred to throw away something you didn't use as opposed to letting someone else use it, you said that you DO use your frequent flyer miles. Why?


Mark wrote:
Well, there is an unwritten rule among men that opportunities to get laid have to be observed, so I can completely understand if a friend wants to spend time with his woman vs. time with his male friends. As far as male friends, they are nice, we get together once a month to drink beer and yak, but I spend probably 10 times more time with my female friends. So yeah, I guess I am of the same mind in some regards.

So what have you got against just going out and buy a plane ticket like 95% of people who fly? You aren’t the one putting up with the bullshit security, cramped seats, crappy food, delays, cancellations, lost luggage, etc... so the one little perk I do have is an opportunity to upgrade with the miles I do have. Once I get platinum status life only gets better, and you want me to give that up? *ahem*...


I wrote:
“I guess I am of the same mind…”

This is very sad for me to know, and strikes me as an awfully shallow way to live. If you should ever reach a point in your life at which you value friendship over orgasms, I’ll be here.


Mark wrote:
Okay, shallow and laid, or intellectual and unlaid... that is the question... it might help to explain why there aren’t many intellectual people out there.


I wrote:
“Okay, shallow and laid, or intellectual and unlaid... that is the question...”

No, that is not the question. The question has nothing to do with how much a man knows about any number of particular subjects. The question is one of values, of character. No one can be friends with a drug addict because a drug addict will betray him. Women are your drug. You say you are of “the same mind” as Carlos, the man I visited in Missouri. Carlos was excited about my visit until he found a girlfriend. By saying that you are of “the same mind,” you are telling me that I am of no more importance to you than I was to him. You are telling me that you are willing to betray a male friend in a heartbeat, and not even because you LOVE a particular woman, but simply to get inside her pussy. A male is nothing to you; a female is something to masturbate into. Since you are of “the same mind” as Carlos, what happened to me when I visited him might just as easily happen to me if I visited you. Aside from the frequent flyer mileage and which time you were being dishonest (whether you don’t use it or whether you value it highly as a recompense for all your airline related suffering), you are telling me that, as a male, I should accept my unimportance to you as an “unwritten rule.”

You called me one night several years ago, and called me brother. That meant a great deal to me, maybe the moreso because the only brother I ever had was a half brother who chose not to have any relationship with me. I imagined that it meant a great deal to you too. Now you tell me that you are no better than a man who, if a slab of pussy was on one side of a balance scale and a longtime friend on the other, he would grab the pussy.

At 59, my lust for women has diminished greatly. Things about them that drove me crazy years ago now strike me as empty or even silly. Hormones clouded my view. They made that which was of little rational importance appear to have paramount importance. I can well understand why I betrayed Peggy (just as I can understand why you would betray your male friends). Lust can feel as urgent to extinguish as having your hair on fire. Peggy could never understand its power over my life. I can understand its power over your life. However, I can also tell you in complete sincerity that lust caused me to value the trifling over the profound. It caused me to betray a good woman for a string of sluts, and it caused me count my male friendships as less interesting, profound, and important than my female friendships (i.e. my latest piece of ass). Now, I don’t miss any of those women, but I miss my male friends (some of whom are dead) terribly. True friendship is of infinitely greater value than pussy; and male-to-male friendships are, at their best, of greater value than male-to-female friendships, because women will ever be like an alien species to us.

I have often been impressed by your empathy and compassion toward suffering animals, and I know that these virtues are permanent whereas your lust for women is largely hormonal and therefore temporary. Yet, for now, you have told me straight-out that you place little value on our friendship. What would you have me do with that information? I could hang around hoping that you don’t mean it, but I have found that people generally do mean what they say when they are telling me something that they know I won’t like hearing. Or, I could say that it’s okay that you don’t value me, but that would mean that I don’t value myself. My other option would be to think of you as someone who I also hold in little value, but we go back too far—and were once, I thought, too close—for that. While you were never my best friend, you were my good friend, and I imagined that you valued me similarly. Ironically, if I had never made a move toward becoming closer to you—by visiting—none of this would have come up, and I would have been left thinking that you valued me more than you do.

Short Rants, Etc.

Today's rants.

Littering
…is an ironic activity. I would have thought that people who litter are neat-freaks who can’t stand to carry trash around in their cars, but what I have observed is that litterbugs are pigs whose cars look like (what else?) a pigsty.

Capital punishment
…I’ve fixed three flats in three weeks on three of our four bikes. A lot of flats are caused by broken bottles, and a lot of bottles are broken on purpose, some of them on bike paths. It is the kind of thing that makes me favor capital punishment. I’ve never understood why capital punishment is reserved only for big things instead of things that are senseless—like breaking bottles on bike paths. Let’s say a woman kills her husband. He beat her for years, and one day she exploded, and blew the s.o.b. away while he was taking a nap. I could understand that. I could have sympathy for that. I could cut her a break for that—just so long as she didn’t litter.

Feelings
…I imagine that my feelings—or at least my emotions—run deeper than those of most people. I try to hide this, because to feel so intensely looks weak if not unstable. Maybe I am weak, and maybe I am unstable, but that’s beside the point. Besides, maybe I’m neither weak nor unstable; maybe I’m strong; but again, I’m talking about how I want to appear, although it’s hard to defend wanting to appear to be other than I am, especially considering that I usually have so little respect for those people whose respect I seek.

I’ll give an example of the kind of feeling I’m talking about. I cry when I hear Jimi Hendrix. I do this because he could make a guitar come alive like no one else, and because his life was tragic and ended when he was twenty-six. Sometimes, I even cry over a comedian if the comedian is really good. It’s not just sadness that gets me; it’s excellence. Only, as I see it, excellence is sad because its over in the flash that we call life, and because to be excellent in our society—maybe in any society—is like smelling good in a pigsty.

Damn cars
…A car nearly hit me today while I was on my bicycle. This happens rather often, partly because the law doesn’t require that cars maintain a minimum distance when passing. Such a bill was introduced, but the cops argued that it would be hard to enforce, and the truckers insisted that maintaining any required distance would be a hardship. Think about that. On one side of the scale was life, and on the other was convenience, and our lawmakers chose convenience.

Despite my worthlessness to legislators, I don’t think I should have to play Russian roulette every time I exercise my legal right to ride a bicycle. Furthermore, I should like it very much if the man who nearly ran me down today had to put his life in the hands of hundreds of harried, negligent, and even hostile strangers every time he runs an errand. I don’t think he would appreciate being passed that close, even if he were in his car surrounded by metal and protected by air bags and seat belts. Maybe he felt confident that he wouldn’t hit me, but no one’s skill or judgment is infallible, and it wasn’t him who would die.

Suicidal authors
…Having finished one biography of, and more than one book by, Robert E. Howard, author of the Conan series, I’ve gone on to one biography of, and more than one book by, Hunter Thompson, author of Fear and Loathing in Las Vegas. Both authors were messed-up people who shot themselves in the head—Howard with a .380 when he was thirty, and Thompson with a .45 when he was sixty-seven (I was surprised to learn that even a .380 can go all the way through a man’s head, but that’s another matter). So, one wonders, why did Thompson hold out for twice as long? Well, he—by implication—attributed his survival to illegal drugs. Howard didn’t do drugs—probably no one did drugs in Cross Plains, Texas, in the ‘20s and ‘30s—although he did get a little drunk with his friends from time to time. I’m also reading a book about the Beat writers, most of whom were also crazy, and most of whom also did lots of drugs and were incredibly self-destructive even when they didn’t out-and-out kill themselves.

I wouldn’t want it to be thought that I am only interested in insane-addict-suicidal-writers, although such qualities are a recommendation. The truth is that an insane society defines as sane those who mirror its insanity. This means that a certifiably sane person is unlikely to write much if anything that is arresting or original. Of course, many of the certifiably insane might really BE insane, and therefore have only gibberish to contribute, yet the insane are what I’m left with after having defined society as insane and those who adapt to society as equally insane.

Health
…I just came from an appointment with my shoulder orthopedist. He seemed much nicer today in little ways like shaking my hand and showing an interest in my condition, rather than not shaking my hand and sitting just inside the doorway looking bored. The reason for the change appeared to be the pretty young medical student who accompanied him. He gave me a steroid shot in my left shoulder when I last saw him, and told me to come back for one in my right if it helped. It did, and that’s why I was there, yet he declined to give me another shot for no apparent reasons than that no one told him that was why I was there, and he was running late, and he had a sweet young thing with a clipboard following him. He advised me to come back another day if I really thought I needed a shot, and I told him that I was there on this day for that very reason. Still, he demurred, and I left feeling mad at myself because I hadn’t insisted. The fact is that I need him more than he needs me, him being one of the few shoulder specialists in Eugene.

I don’t sleep well on either side or even on my stomach due to pain in my shoulders, and I don’t sleep well on my back because it too hurts by day and by night, but especially by night. I am tired of living with pain, but I don’t see an end to it. Everything I do to help myself either serves as a temporary fix or makes matters worse. My groin still hurts despite hernia surgery in early spring, and my wrist still hurts despite carpal tunnel surgery in late spring. Then there is the arthritic and chondromalacial pain in my left knee, tendon pain in both shoulders, fingers chilled by Raynaud’s; at least three sleep disorders; and, as of last winter, chronic back pain.

I imagine that I must surely be doing something wrong to cause all this pain, but I don’t know what to do differently. Some people say that I am simply getting old, but if the level of pain I am experiencing at 59 is normal and will increase, I don’t see why anyone would even want to reach seventy.

My challenge is to keep a positive outlook, because continuing as I am is unthinkable. Until my knee surgery three years ago, I was strong as a horse. Now, I feel like an old man who must be careful lest he further injure himself.

Mississippi funeral

My Mississippi trip was more like a family reunion interrupted by a funeral than a funeral accompanied by a family reunion. I saw some people I hadn’t seen in a quarter century, and I saw others who I had never seen because they weren't born or hadn’t married into the family. Even people I didn’t get along with seemed genuinely glad to see me, and I them, although by the time we parted we remembered why we had not gotten along.

Some stories and reflections.

The flight. I haven’t flown since long before 9/11, so I tried to imitate everyone else when I went through airport security An alarm sounded. The guard looked at me like I was supposed to know what to do, and I looked at her like she was supposed to offer some suggestions. The moments drug on, but I finally won. “Did your forget your cell phone,” she asked. “I don’t own a cell phone,” I answered. “Well, do you have any metal in your pockets?” “Yes, I have lots of that.” Who would have thought that TSA would expect me to unpack my own bag for them to inspect? I felt so…so virginal.

I told my seatmate on the plane that I had really wanted a window seat because I hadn’t flown in a long time, and would like to look out. He grunted and closed the shade. “The sun hurts my eyes,” he explained. When he went to bathroom, I leaned over and opened the shade. The snowcapped Rockies greeted me in all their majesty. When he returned, I asked to trade places. “I would have to move my things,” he protested. His things consisted of one paperback and one jacket. “Well, if it’s too much trouble…” I said. He traded.

From 31,000 feet, the Old Man didn’t look like a river. It looked like mud—beautiful, horizon-to-horizon, mile-wide mud. My heart leaped and became stuck in my throat. Then came the meandering Yazoo and the mysterious Big Black and, to the north where the earth drops away abruptly, the cotton fields of the Delta. I saw four lane roads that had not existed when last I visited, and I saw sprawl, more sprawl than I could have imagined. As the plane braked and grew silent on its approach to Jackson, I spotted the Ross Barnett Reservoir and the sandbars of the sometimes mighty Pearl. Memories of battles and freedom marches, of ignorance and poverty, flooded upon me, and I felt engulfed by compassion for my beautiful state that has suffered so much. “Oh, please don’t touch,” I implored the plane’s wheels, “let me love it from a safe distance.” And so I arrived in Mississippi.

The airport, which used to be called Thompson Field in honor of a Jackson mayor, is now Medgar Evers’ International. I know little of Alan Thompson, whereas I greatly respect Medgar Evers, yet I interpret the alteration as indicative of nothing nobler than a regime change. When the whites took Mississippi from the Indians, they renamed most things, and now that the blacks are in charge, they are doing the same.

The weather. Hot and humid by night and by day. My mother believed that night air contained vapors, so we slept with the windows shut when I was a boy. She also opposed drafts, so we slept without fans. Now air conditioning is to Mississippi what furnaces are to Minnesota. I didn’t mind the heat this time because I was like a tourist in pursuit of the full monte.

Heat and humidity multiply odors many times over, odors of flowers, of mown grass, of sub-tropical decay. The intensity was so marked that going to Mississippi was like going from not smelling anything to smelling everything, and I loved it.

Every afternoon, the thunderheads would build, the weather warnings would become frantic, the rain would descend, and the steam would rise. Five minutes later, the show would be over, leaving the air twice as hot and the odors of dirt and grass and asphalt twice as strong. This too I loved. Plants love it also. Oregon plants pop vitamins; Mississippi plants mainline meth. When I was a boy, plants like bananas and elephant ears that had big leaves and grew really fast scared me. I didn’t literally believe they would drag me from my bed and eat me, but I didn’t turn my back on them either. I used to be able to identify sixty to eighty Mississippi trees, many of them by their shape and shade of green, and I was sorry to discover that I’ve lost that ability.

Buckner. This is the town of 900 where we stayed. Like a lot of towns in the area, Buckner is 80% black. Peggy’s father, R.W., told us not to go walking at night, and to avoid some areas even in the daytime. I remember a time when I could walk anywhere at any time in any town or city in Mississippi. Now, Jackson hides behind burglar bars, and meanness sells newspapers. During my visit, a man was shot in the back because he refused to give a cigarette to a stranger. Another man was killed while sitting in his car, although he had complied with the killer’s demand for his wallet. Some people say that the killing is caused by drugs, but Oregon has a drug problem too. Since the meanness began toward the end of the civil rights era, I imagine a connection. Fear once kept poor blacks in check, and there didn’t used to be nearly so many of them in proportion to the number of whites.

A few black people came to the funeral home, and two of R.W.’s grandkids—who stayed at his house and attended the funeral—are half-black. Mississippi is the most integrated state in the union. Where there is separation—like in regard to where a person attends church—it is by choice rather than coercion. People in Oregon don’t want to believe this. What really irks me about people in Oregon is that they can go for weeks and not even see a black person, yet they declare themselves free of prejudice and believe they have the answer to every racial issue. The way I see it, such “racial” problems as do exist in Mississippi are caused by culture rather than race. Where there are only a few black people—like in Oregon—they adapt to the white culture, but where there are many, things are different. Yet, I fully believe that racial goodwill dominates in Mississippi. I saw too much of it to think otherwise.

The funeral. The casket was open for the visitation. Peggy hadn’t wanted it that way, but that’s the custom, and that was what her father preferred. The visitation started three hours after I got off the plane. I had slept two hours the previous night, seven hours the night before, and no hours the night before that, so I had a hard time greeting person after person, many of whom I was supposed to remember from long ago. God, but most of them looked like hell. Leave town for a couple of decades, and get a lesson in human frailty and temporality when you come back.

I was a pallbearer just as I was at the funerals of three of Peggy’s grandparents. One of the pallbearers was stung on the lip by a yellow jacket, but he toughed it out. Otherwise, things went well, with the afternoon’s five-minute rain occurring on the drive from the church to the cemetery.

I didn’t cry, although I tried. It wasn’t so much that I wanted to project a caring image as that I felt I owed it to Peggy to grieve. I tried to remember moments when Mom and I had fun together and other moments when she seemed happy, but they got washed away by angry memories. Memories of her ordering R.W. around like a slave, and of neglecting to stay in touch with Peggy. Peggy used to cry about her mother’s indifference, saying it was because we didn’t have children like her two sisters. Instead of boxing my anger up and putting it away when Mom died, I became madder than ever. I had wanted to love her, and I had wanted to respect her, but she was, by her own admission, a misery even to herself. I could but grieve over my inability to grieve.

My only remaining brother-in-law looked like he might be feeling pretty much the same, but then white people usually keep a stiff upper lip at funerals. This is another difference between them and black people. Black people howl, wave their arms, and throw themselves to the floor. White people might feel like doing that, but they would lose face. For some reason staying in control means more to us, even when our control isn’t believable.

The rest. I spent most of my time sitting around the kitchen table visiting. I enjoyed myself and wished that my life had more people in it with whom I could do that. The food was bad—lots of desserts that people brought over and nothing whole grain—and I pigged out. I can only say no to bad food by not being around bad food. The funny thing is that I don’t enjoy bad food a whole lot, partly because I can’t stop feeling ashamed of myself for eating it.

Despite R.W.’s warnings, Peggy and I took a walk everyday. One night, I stayed home while everyone went out to eat, and that night I walked for two hours. The songs of frogs and crickets pulsed loudly, and I thought about what a shame it was that everyone else in town was sitting beside their air conditioners.

I marveled at how beautiful Mississippi is, and I asked myself if I could ever move back. I could, I thought (the winters in Oregon get me down), but I knew Peggy could not, and I was grateful to be safe from the possibility. It’s as close to a third world country as I have seen because there is so much squalor and decay. Even the concrete looks different. Here it is made of crushed basalt. There it is made of chert, and looks bleached and ancient. I got the biggest kick out of just walking around staring at the concrete in Buckner, every slab of which was cracked. Maybe that’s why none of the many black men who didn’t appear to have anything to do all day messed with me—maybe they thought I was dangerously insane. Other than Peggy, I was the only white person I saw on the sidewalk the whole time I was in Buckner.

Another thing Mississippi has in common with the third world is that graft is considered more or less normal. For example, Mississippi has the worst schools in the nation, and Buckner has the worst schools in Mississippi, yet Buckner spends more than twice the Mississippi average per student, and no one seems to know where the money goes. They just see a lot of poorly paid state employees driving around in Mercedes. If I lived in Buckner, I would have to fight the corruption. That’s just how I am.

Long drive from Portland

Peggy’s mother died last night.

During the years that I dealt with people in crisis—as a funeral director, ambulance driver, phlebotomist, respiratory therapy technician, and peer counselor—I developed the belief that I had a greater than average ability to help people whose lives were in turmoil. I have since discovered my error. After 37 years of marriage, I can no more tell what Peggy is feeling than if we had recently met. It’s not that I’m oblivious, but rather that my perceptions run in reverse to her reality. If I think she is angry, she is as likely as not to be in a pacific mood; or if I ask her if she is sad, she will often tell me that she is happy. Such mistakes are the norm rather than the oddity, and I can but reflect that if I am incapable of discerning Peggy’s moods, then I can certainly entertain no hope of understanding anyone else’s.

Some years ago, Walt and I had many of the same friends, at least until Walt told me that, without exception, they could find nothing good to say about me in my absence, that they were, in reality, pretending to be my friends so as to not hurt my feelings. When I approached people about what Walt had said, they denied it flatly, and accused Walt of being the one who not only could find nothing good to say about me, but was trying to turn everyone else against me too. This left me considerably confused, yet they have, to a person, left my life while Walt remains. Maybe that’s what he intended.

Walt and Peggy are the people I am close to, so if they tell me—in effect—that I cannot trust my perceptions of others, then I have to take that seriously. The paradox is that, if it is true, then neither can I trust my perceptions about them. I am therefore left to feel that I don’t—even that I can’t—know anyone deeply. I view other people as if they were standing on the wrong end of a telescope. This has caused me to feel so estranged from my species that, if half of them were to die tomorrow, my only concern would be the effect on the financial markets.

Peggy very much needed my emotional support last night when she learned of her mother’s death, but I was at a loss. I could make her airline reservations, pack her lunch, and drive her to Portland, but these were concrete things that I knew how to do, and the effectiveness of which I could judge. By contrast, I had no faith that I could understand what Peggy was experiencing, and I felt that my every word to her was wrong.

I looked forward to the sunrise on my drive home, but instead the air grew chilly and a steady drizzle fell. I hadn’t slept, and—at 5:00 a.m.—had already consumed more than my daily ration of coffee. Johnny Cash sang the same sad songs over and over on a CD, and I brooded over my inability to understand other people in any significant way, and, furthermore, on their inability to understand me.

I thought about how quickly I could end my alienation by running the car into the end of a guardrail. Every guardrail I came to appeared to have been designed to minimize such an impact, but I figured that a speed of 120 ought to do the trick. I even told myself that, since I was in a rental car, Peggy wouldn’t be inconvenienced by having to buy a new vehicle. But, I also thought about what a blow my death would be to her, especially now. Still, the thought was tempting by virtue of its quickness. Then I remembered that the dogs were with me, and my unlikely fantasy came to an end.

I live among feelings as a blind man lives among colors.

When Robert Howard’s mother died, he killed himself. Actually, he didn’t even wait for her to die. When she fell into her final coma, he shot himself in the head. He was thirty; the year was 1936; and the place was Cross Plains, Texas.

Reading Robert Howard’s horror stories at bedtime makes for some interesting dreams. Two nights ago (the last night that I slept), I dreamed that I came upon an automobile accident. An old man was laid out on the sidewalk. He said he was afraid to die and pleaded for reassurance. As I drew closer in the dim light, I saw that his entire face above the mouth was gone, and his brain with it. As I stared into his empty skull, I was stricken with grief and horror, yet I wanted with all my might to comfort this corpse that had yet to learn that it was dead. To want so much to give, yet to have nothing to offer beyond, at most, what might be called logistical support brings me great sadness.

I spend my life confused. I can’t even say how much of what I just wrote about who I am is true. My dilemma is that, if Peggy and Walt are right about my inability to understand other people, then how can I trust that I understand myself? I can but offer that my feelings do not appear to me as either truths or lies, but as winds that blow through my head, and who can stop the wind?

Years ago, I met a man in Minneapolis who said he envied me because, “You know who you are, and I have no idea who I am.” I had never imagined such a scenario, and couldn’t comprehend what he meant. That was twenty years ago, and I know much more now than I did then, but who I am is no longer something that I know. Like a haunted Mayan village in a Robert Howard story, I have entered a realm that was easy enough to get into, but doesn’t appear to have an exit. I don’t mean that it is an altogether bad realm, because my sense is that it has more depth and, I think, more truth than the solid me I once knew—or imagined. If my expectations of how I can relate to other people are excessively dour today, they were excessively optimistic when I believed that every river could be bridged, every wound could be healed, and no one needed to be alone.

I believe that people survive either by denying the fatal futility of their brief existences or by compartmentalizing their minds so they don’t dwell on it. If I could do the same, I would. After all, what would I lose, truth having outlived its lustre?

Cheapskate

The judge reduced our tickets from $257 (each) to $65. At that rate, the city didn’t make any money, and the cop would have done society more good had he sought to enlist our cooperation with a warning rather than to beat us into submission with a fine.

Peggy’s mother lives, so after 15 days in Mississippi, Peggy came home. When she flew down on the 6th, everyone anticipated Mom dying within days. This meant, at worst, two last minute plane fares. Then Mom was moved into hospice, and was taken off her fourteen prescription meds. Not surprisingly, she rallied (or at least she didn’t die), and Peggy predicted a lengthy demise. This meant that we were up to three airline tickets. The more I thought about spending nearly a grand to go to anyone’s funeral, much less the funeral of someone I wasn’t close to, the more I resisted. Of course, I told myself all the right things: “You are not going to bury the dead, but to support the living.” “Family means more than money.” “Peggy’s mother will only die once.” “You can afford it.” “You are an unloving cheapskate.”

I could see that all of these thoughts except the last one were good thoughts, yet I resisted, so, after a few days of feeling down on myself, I began to ask why I was making such a big deal out of a thousand dollars. For a while, all I could think of was that I was cheap, but this didn’t give me any insight. Then one night, I awakened from sleep feeling anxious and with the following sentence running through my head, “Money is all that stands between you and the wolf.” This isn’t entirely true, since Peggy has her nursing skills, and I could work as a handyman if not as a teacher. But occupational skills are dependent upon many factors (such as health); and Peggy is tired of nursing; and I really don’t want to do either of the jobs I could do. The fact that the stock market has taken such a downturn that there have been single days on which our various accounts have posted losses in the thousands of dollars hasn’t boosted my benevolence quotient either.

With greater understanding came greater resistance, and I told myself that I would simply have to be strong in refusing to go because I would be acting for the good of both of us, even if Peggy didn’t see it that way. “Well, but what if she says she will never forgive you?” I asked myself, and concluded that, if she felt that strongly, I would go rather than run the risk that she meant it.

Peggy came home with a $3,000 check that her father gave her for our airfares. “Of course, I can’t cash this,” she said, and I assured her that I knew someone who could—something she would have known when she accepted it.

I used to wonder how I could survive without my parents, but, now that they’re gone, I’m just glad to be on the other side of the experience. If Mom were a dog, we would euthanize her and call it an act of mercy, but, since she’s a human, her suffering and the suffering of her loved ones must be prolonged.

Wimawhala Encampment

I just came from a meeting of the Wimawhala Encampment, which is a lodge that I joined last winter because it is dying. There are six of us, and each is an officer. We call ourselves patriarchs, and our emblem is a nomadic tent. Instead of a gavel, our “chief patriarch” calls for order with the top of a walking staff. Our other officers are a treasurer, a scribe, a high priest, and two wardens. I am the junior warden, which means that I will assume the role of chief patriarch in two years. I am also the junior warder in my Masonic Lodge, so I’m expected to move into the worshipful master’s station there in two years.

There are two ways in which I look at my lodges. One is to think that much of what we do (like using the top of a staff as a gavel) is just too silly for words. The other is to ponder our symbolism (the Encampment’s tent stands for safety and hospitality) and to listen to the words we say, and to think that lodges are awfully sweet. Ironically, if lodges were flourishing, I probably wouldn’t fit in.

Awe of the Mighty

This summary is not available. Please click here to view the post.

Double traffic tickets

Peggy and I got simultaneous traffic tickets last week for running the same stop sign on our bikes. All we could figure was that the cops were inspired by the recent death of a bicyclist two blocks away. Since then, I have diligently stopped at every stop sign. I am the only bicyclist who I have seen do this, and the others look at me strangely as they go around. I resented the $257 (each) tickets. There are two sets of laws. One set is written in the books. The other set is the ones that are actually enforced. For example, Eugene has a law against car camping on public streets, but the cops won’t enforce it. Instead, they advise complainants to ask St. Vincent DePaul to come out and help the campers (St. Vincent’s has a city contract to do this). Personally, I don’t want to help street campers—I just want them gone.

Justified tickets are easier to accept than are tickets based upon the arbitrary power of the issuing officer. When I asked our cop why we were being singled out, he assured me that the traffic laws are always applied equally. I hold that lie against him infinitely more than I do the ticket, because I could see where the ticket might have come out of his desire to protect the public, but I couldn’t see how the lie came out of anything but his knowledge that he could bullshit me all he wanted, and I would have to stand there and take it for as long as he wanted. Being constrained under threat of violence to wait passively on the curb while a cop writes you a ticket is a mini jail sentence.

I set about trying to get our tickets reduced (by writing a letter to the judge) as soon as I got home. Peggy and I were supposed to sign below one of four paragraphs on the back of our tickets before I took them—along with my letter—downtown. These paragraphs were badly written to the point of having numerous grammatical errors, and neither of us could figure out whether we were supposed to sign below paragraph two or below paragraph three as they seemed to say pretty much the same thing. Two days and numerous tries later, we still hadn’t figured it out, so Peggy signed both paragraphs on the back of her ticket the morning she flew to Mississippi. Our plan was that I would find out which one she was supposed to have signed, and cross the other out.

When I asked the lady behind the counter at the municipal court which paragraph was the right paragraph, she said she was not qualified to offer legal advice and advised me to “seek the services of an attorney.” Of course, it was an attorney who wrote the stuff in the first place. Lawyers make money by making the law as incomprehensible as possible. Since they can’t agree among themselves what it says, still more lawyers have to be hired to take matters to court where lawyer-judges decide. Sometimes many lawyer-judges in many courts over many years are needed but the lawyers are okay with it since they are all making hundreds of dollars an hour. As I read on the back of a pre-folks t-shirt, “A lot of people are alive simply because killing them would land you in jail.”

Mom nearing death

Peggy’s mother is dying. She is sometimes rational for brief periods during the day, but at night she forgets where she is and who her family are. She then becomes frantic and pleads for help, sometimes all night long. In the daytime, she is apt to become stuck on the same sentence which she repeats without pause hour after hour. One day, it was “Like sands through the hourglass, so go the days of our lives.” Other times, her mantra is a continuation of her pleading from the previous night.

Peggy is in Mississippi standing vigil. My parents being dead, I tend to focus on what a relief it is to have that kind of thing out of the way, and to wish that it could be out of Peggy’s way too. “Mom” is miserable. The lives of her loved ones are stuck while they await her passing, and, at 78, her husband won’t live long enough to pay off the medical bills.

Like, have a nice day, folks.

(This entry contains several instances of the F-word.)

I don’t remember the last time I heard the word people. I grew up thinking of folks as a low class word for family—something Jed Clampett would have used. After 9/11, I was shocked to hear George Bush refer to al-Qaeda as “folks,” but I remembered that George Bush was the very person who had caused me to lose all respect for a Harvard education. Next, I noticed that black people on a NPR program aimed at a black audience only used the word folks to refer to two or more people. I was disappointed, but observed that it was, after all, not a program that targeted the educated. Now, everyone on NPR—interviewers and interviewees alike—uses the word folks exclusively. Nobel Laureates are folks. Neo-Nazis are folks. The Founding Fathers are folks. Polygamists, entomologists, and Arctic explorers are folks.

It is both a blessing and a curse of aging to realize that things are not as they used to be, and to further realize that people who don’t remember how they used to be are probably unaware of the changes (an observation that keeps me from taking historians too seriously). Yesterday, a store clerk told me, “Have a fabulous day.” She flashed a toothy smile, which caused me to wonder how many times a shift she was able to carry off the performance. I speculated that she must be, like, so totally bored with “Have a nice day” that she was simply trying to come up with an alternative. As I turned to leave, I said, “Thank you,” “No problem,” she answered. “At least there’s that,” I muttered as I wondered when “you’re welcome” became passé.

I first heard “Have a nice day” in 1974. The teacher in the classroom next to mine said it to each of the thirty students in each of her five classes as they walked out the door. She never personalized it with a name; never said “Study hard,” “See you tomorrow,” “Don’t forget to bring the homework that you claim to have forgotten,” or even “Later Gator.” “Have a nice day” it was, 150 times a day, 750 times a week. Her students behaved exactly as they would had she said nothing, had she not even been there.

Editorialists opposed the nice day mantra on grounds of inanity, and because it was worded as an imperative. I waited in vain for the fad to pass. Thirty years later, I’m still waiting. I never observe language moving uphill. New words are added at an astonishing rate, but the overall effect is to express the same sentiments with ever more of the same imprecise words, which means that a great deal of what is said is meaningless.

“Me and him, like, you know, like, fucking think that not being able to smoke in a fucking bar is, like, totally fucked—you know.” When I eavesdrop on conversations among the young (to whom one my age is invisible), this is often the level of discourse that I hear. “We despise the new law against smoking in bars” would do, so why the excess? I would have supposed that the ever-increasing volume of words that comes at us everyday would have inspired us to speak more succinctly, but I’ve concluded that it is this very volume that causes individuals to hold the floor as long as possible. So, what do you do when you want to keep talking, but you have nothing more to say? Of course! You, like, uh, you know, like, fucking drag it out.

We are also under-educated. A Russian penpal wrote that she learned to speak English better in a few years than most Americans do in a lifetime. She had met a great many of us, and concluded that we are fat, boorish, spoiled, ignorant, and would have already gone down the toilet were it not for our inherited wealth. I wanted to defend us, but I had no defense. All I could think to do was to ask her why, if America is so bad, thousands of Russians are trying to move here whereas no one from here is trying to move there, but such a talk-radio tactic would have been an evasion rather than an answer.

Illogic in sermons

I sometimes attend Sunday school at various liberal churches. The service itself is another matter because I usually take issue with the sermon. From last Sunday at the United Church of Christ.

Says Jesus:
“Take no thought for your life, what ye shall eat, or what ye shall drink; nor yet for your body, what ye shall put on…. Behold the fowls of the air: for they sow not, neither do they reap, nor gather into barns; yet your heavenly Father feedeth them. Are ye not much better than they?”

Thinks Lowell:
“What is the basis for this comparison? I might be better than birds in some ways, yet I lack the ability to fly, and I have no internal compass to guide me across oceans and continents? Besides, Jesus, isn’t it a little self-serving to choose birds for your analogy—why not beavers or squirrels, animals that are obliged to make provision for tomorrow? Finally, what happens to the bird that becomes unable to catch fish or insects—does the Heavenly Father still feed him? I think not.”

Says the preacher from the preceding Sunday:
“My friend the atheist says, ‘Show me God,’ and I respond, ‘Come to my church, and you will see him in the people there.’”

Thinks Lowell:
“Huh?! How do you know it’s God that makes people act differently in church. Would it not make just as much sense to attribute their behavior to space aliens or formaldehyde emissions from the carpet? Or how about this; how about they act differently because they’re in a controlled environment in which niceness comes easily, is socially obligatory, and can be dropped before lunchtime?” Lowell then looks around to see if anyone wags his head or smiles wryly at the preacher’s blatant example of begging the question. No one does, and he wonders if they were listening.

The service moves on. Near the end comes a ceremony for those members who died since last Memorial Day. Their family and friends light candles as their names are called, and then “Shall We Gather At the River” is sung. Lowell gets misty-eyed. As he tries with limited success to pull himself together, he asks himself why he was touched? Did he catch a glimpse of THE truth that must elude any preacher’s faltering logic, or was he simply reminded of those many people he sang this song with a half century ago, people he cared about who are now dead? Occam’s Razor (the simpler explanation is more likely to be true) would favor the latter, but he cannot be sure. The mystery is ever before him.

Windfall

We just took our first camping trip of the year, a two-nighter to the Old Cascades. Windfall had the road to our destination—Windy Pass—blocked, so I got out my new Gerber backpacking saw and my old Boy Scout handaxe, and went at it. After clearing a few blockages, we began to suspect that the problem wasn’t so minor as we had hoped. We unfolded our bikes and set out to see how far the windfall continued. After a half-mile, we gave up.

We camped in the road, right at the spot where we had stopped our clearing efforts, and tried another road the next day. It too was blocked, so we tried a third. It had a few blockages, but nothing we couldn’t handle. After finding a congenial campsite on an abandoned logging spur, we set-off up a jeep road on our bikes, but ran into snow at 3,500 feet. We can bike over firm snow, but this was so mushy that we found it hard to even push our bikes through. Soon the snow grew deeper, and the areas with snow became more numerous than the areas without snow, but we persisted for two miles.

The third day, we descended to 2,500 feet, and found a biking route that was idyllic. Warm but not too warm; sunny, but with just the right amount of shade; a singing brook every quarter mile; myriad wildflowers; tender new leaves; and, of course, the company of my young bride. I never had a better day. The only downside was that I drug the blade of my saw across the back of my fingers and hit an artery. I was dreadfully embarrassed, the more so because I had drug the same saw across the same hand the day before but with less effect. The bleeder made me pretty much worthless for purposes other than holding my tightly bound hand in the air, but I had been in the process of cutting the last downed tree that lay between us and home anyway. Peggy will now be doing dishes for a few days.

I often think of living in the woods, not in a house, but in my van. I would camp at the end of abandoned logging roads, and hide their entrances with brush. When I tired of one spot, I would move to another. I know this is a fantasy that probably looks better in my imagination than in reality, but it’s an old fantasy, and one that I might try someday.

Lilies and Car Tags

We are having our first warm days since last fall. I bike amid greenery, my wheels afloat, winter’s gray defeated by color.

I’m selling my car tag collection on Ebay. Between Ebay and Craig’s List, I’ve sold seventy items this year—two air purifiers, some tap dance shoes, a $450 backpack, a Champion Juicer, a climbing helmet; all stuff that weighed on me. But then all that I own weighs on me; it’s just a matter of what I’m ready to let go of. Right now, my father’s potted lily is in the driveway waiting for a passerby to give it a new home. If he had bequeathed me a compact cactus, I would have been okay, but his lily has all the exuberance of a Walt Whitman poem, and I never wanted it. For the fourteen years since he died, it has resided on a table in the den making it impossible for Peggy and me to see one another when we watch TV. A thousand times, I’ve wanted to get rid of it. Now I am. Maybe. My father’s lily defines my relationship with the things I own.

Louisiana car tags from the fifties and sixties bring up to $80. Alabama does well too, but Mississippi tags often fall short of Ebay’s 99¢ minimum. I’ve written a couple of times to a man in my hometown of Brookhaven, a man I met on Ebay. He collects Mississippi tags, and I tell him he’s lucky, because he can get them cheap. It’s better to treasure things that no one else wants. When I was a boy, I collected model horses, and would look through store shelves for any that had broken legs. I wasn’t trying to save money—I didn’t even know I could save money—I just knew that no one else would want them.

I have a molasses jar full of Pacific Ocean beach sand that I bought at an estate sale in Minnesota. The jar was filled on Friday, July 25, 1952 (according to the writing), and I bought it because I knew that it would be thrown out. I verified this by returning to the sale when it was closing.

I once thought that I would be happier if I didn’t own so much. Now, I’m not sure; I just know I feel lighter, because ownership—at least of the nonessentials—represents slavery. Peggy and I spent a summer in Fresno where she worked as a traveling nurse. We only took with us the things that would fit inside our Ford Tempo. One of my fondest memories of that summer is of only owning one kitchen knife (a Buck hunting knife that a brother-in-law had given me). Since it was only one knife, I kept it on the countertop, and, since it was our only knife, I kept it sharp. That was a tough summer in that we had no idea which direction our lives were about to take, us so I can’t say that it was a happy summer overall, but I smile when I remember the joy of owning so little.

Peggy loves to own things, and the only thing that tortures her about them is the fear that someone might steal them. I worry about this too. I even hate to leave on vacation, because I worry about something happening to Peggy’s button collection. I worry about Peggy’s buttons more than Peggy does, because protecting Peggy and her stuff is my responsibility. Also, she uses her button hobby to shield herself somewhat from the evil of the world, and I don’t know how she would fare if that evil stole them. I don’t even know if a thief would want her buttons. I’ve gone back and forth about the matter, and my conclusion is that I can’t say he would want them, but then again I can’t say he wouldn’t.

Dad’s lily is gone. I was happy when I noticed it missing, but then I saw it on the porch next door. I don’t think it will be happy there because of the dry summer winds, so I don’t feel like I have gotten rid of it after all. I might ask for it back.

Coffee at Slocum, The Cooler

I had my surgical follow-up yesterday, and, my other errands having gone smoothly, arrived 45 minutes early. I wanted a cup of coffee, but Slocum Clinic (which, despite its name, doesn’t treat sex disorders) no longer gives away coffee—they sell it. I already resented the change, but after I woke up in post-op, and was told that I couldn’t have a cup of coffee unless I could find someone to go downstairs and buy me one, I really resented it; and resolved that I would never drink another cup before I would buy it from Slocum. So, there I was, riding my bike around the block looking for another place to buy coffee. The only establishment I saw was a bar called The Cooler.

I haven’t been to a bar in maybe twenty years, but, remembering that Eugene bars are smoke free, I decided to take a chance. I intended to buy my coffee and drink it at Slocum (figuring on an act of civil disobedience if challenged), but the atmosphere under The Cooler’s gambrel ceiling suited me. I found a deeply stuffed chair and got out a couple of books (I always take books to appointments). Then it struck me that I frequent bars so seldom that I should take inventory. These are my findings: soft fifties music was playing at a respectable volume; the floor, walls, and ceiling were all natural wood; and there were only four other customers. Two were middle-aged men who were drinking alone, and the other two were a man my age and his companion—a good-looking blond two-thirds my age. I also counted one marlin (stuffed), one moose head (also stuffed), three pool tables, ten mute TVs (on nine channels), a variety of neon liquor signs, and a fair amount of college football regalia.

I enjoyed myself so much that I fantasized becoming a regular, but, right away, I hit upon a problem. The coffee was $1.25, and I tipped the barmaid a quarter. If I went to The Cooler five days a week, fifty weeks a year, that would come to $375. Considerations like this are why I drink my beer and coffee at home. If everyone held my values, a lot of businesses would go out of business.

My doctor’s appointment went well. I’m doing fine he assured me, and I agreed. Then I raised hell about the coffee situation, saying that the nurses hate it too (they can’t even have a coffee pot in their break room) and that one of them told me about the patients who wake up with headaches (having been NPO all day) and mad because they can’t have their coffee. He explained the situation thoroughly to his satisfaction, and concluded by saying that he is on the committee in charge of the coffee cartel, and will see that, “A free cup of coffee comes with every surgery.” We left on good terms.

Sleep Apnea

Obstructive sleep apnea is caused by loose tissue (turbinates, tonsils, uvula, soft palate, etc.) blocking the airway. The problem appears during sleep because that’s when everything relaxes, and it gets worse with age because that’s when everything relaxes more. There are five treatments: tracheostomy, surgery, dental devices, weight loss (if the patient is fat), and a breathing machine called the CPAP. Trachestomies are for when nothing else works. Surgery and dental devices aren’t terribly effective, and surgery also has some curious side effects like making the patient talk like a duck and drop food from his nose. With another surgical method, the patient’s jaw is broken and pulled forward throwing his teeth out of alignment. I’ve already had two sleep-related surgeries. One was for a deviated septum, the other for the same thing plus chiseling bone from my sinuses and tissue from my turbinates. Without the second surgery, I couldn’t have gone as long as I have without a CPAP.

The CPAP (continuous positive airway pressure) does pretty much what it sounds like it does: it pumps air down one’s throat continuously so the airway remains open. How much air varies. Most machines pump a steady amount, but I have a “smart-PAP” that adjusts from a low of ten (cm H2O) to a high of sixteen. Sixteen is one shit-load of air.

The patient wears either a mask or a fat cannula. The first mask I tried created a pressure sore on my nose, and the next three leaked, so I’m using a cannula. The problem with both masks and cannulas—even when they fit—is that they occasionally allow air to escape, especially when the patient turns over. This requires a certain delicacy of movement and considerable adjustment and readjustment throughout the night. Otherwise, the wind that is supposed to go down my throat is blowing loudly across my face or into my eyes, creating the risk of an eye infection.

I try to think of my CPAP affectionately, but that is like thinking of a wheelchair affectionately. On the one hand, I am glad I have it, but on the other, it is noisy, bulky, ugly, bothersome, expensive, requires daily cleaning, and makes it impossible for me to wander from an electrical outlet. This last part is the worst of all because I don’t trust technology to always be there, and because I have a powerful need to escape it occasionally.

I often lie in bed listening to my CPAP, and trying to understand why it behaves as it does. Last night, just as I was getting to sleep, the pressure started going up and down at regular intervals, as if the machine was a large beast breathing on its own. The trouble was that its breath didn’t match mine. It would force me to inhale for too long, but not allow me enough time to exhale, so I felt like I was suffocating. I tried to breath normally in the hope of forcing it to breath with me, but this required that I work really hard, and I soon lost sense of what a normal breath felt like.

I didn’t know what else to do, so I took the same ineffective steps over and over, things like rerouting the six-foot hose, readjusting the cannula, resetting the switch, and even repositioning the machine. I also wondered if I was imagining the problem. After all, it takes some people weeks to work up to using a CPAP for one whole night, yet I’ve used mine all night every night, so maybe the strain was getting to me. I thought and thought about it—which wasn’t easy while struggling to breathe. After awhile, either the machine or I settled down, and the rest of the night passed peacefully.

The main difference I notice with the CPAP is that I dream A LOT. This was even evident in the sleep lab. Without the machine, I dreamed little (and those dreams were often about suffocating). With the machine, I have one colorful and richly detailed dream after another. Maybe I had built up a dream deficit. My theory is that apneas would end whatever dream I was having, and it would take me awhile to settle back into REM sleep, only to be hit by more apneas as soon as I did.

I’ve also noticed that I don’t wake up headachy and exhausted. Instead, I wake up with my nose raw and achy due to the cannula pushing upward against my nostrils. I also wake up with a devilishly itchy throat if I don’t sleep with a harness that keeps my mouth closed. Since I also use a toothguard to prevent me from grinding my teeth to powder, getting ready for bed is tedious, although it’s not the work I mind, but the thought that I will have to do it for the rest of my life.

My father preferred death to pills because—along with his belief that the pharmaceutical industry was ripping him off—he felt that a life that had to be permanently preserved out of a pill bottle was beneath his dignity. I understand his point, and a CPAP strikes me as worse than a whole boatload of pills, but dignity is subjective and death extreme. I don’t know how Dad felt about the indignity of snot, shit, and the bizarre appearance of human genitals, but he survived all of them. This leads me to suspect that—in his mind—the indignity of pills consisted of the dependency he felt upon the despised industry that provided them.

Food for life, he could, and usually did, grow for himself, but pills for life were from an alien source and made of alien materials. They made him feel powerless in a way that congestive heart failure did not, and by choosing death, he regained his power. It was his choice, and I respect it. Most of us never acknowledge that there comes a right time to die. We say we long for heaven, but we will spend any amount of money and put others to any amount of trouble just so our sorry carcasses can breathe for one more day. Like my father, I believe there comes a time when dignity demands that a person say “no more.” I am closer to being there than I was even five years ago, but I hope to tarry a while longer.

Where was my responsible adult?

When you’ve been anesthetized for surgery, you’re advised to spend the rest of the day with a responsible adult, and warned not to make any important decisions. So why, then, is there a ten-pound bag of Costco chocolate chips draped over my kitchen table like a dead moose? Where was my responsible adult, and what was she thinking to let me buy that?

I woke up this morning—following my first night with a CPAP—rested and refreshed for the first time in memory. By contrast, I usually wake up headachy and exhausted after a succession of nightmares, my mattress wet with sweat. According to my polysomnograms, I awaken seven times an hour, and I stop breathing 43 times per hour—during which my oxygen level drops to 83%. I also grind my teeth and jerk my limbs. People die from such sleep. Nobody wants to pass the night with a noisy air pump and a mask that either feels too tight or leaks, but it sure beats the hell out of hardly sleeping at all.

My hand is greatly swollen, my wrist feels like someone drove a spike halfway through it (which is, actually, pretty much what happened), but I feel terrific. Maybe I will soon have the freedom to think more of things other than my health.

Surgery day

The anesthesiologist had said he would knock me out just long enough to get the primary painkiller started, leaving me awake for the surgery. The next thing I knew, I was waking up in another room. I looked at my wrist, saw that it was bandaged, and tried to wiggle my fingers. To my utter joy, they moved. Two hours and fifteen minutes after Peggy and I arrived at the clinic, we left. The doctor said I could do anything I felt well enough to do, so I shopped at Costco, then came home and helped my neighbor dig dandelions. Then Peggy and I went to pick-up a CPAP machine (continuous positive airway pressure) for my sleep apnea, came home, and took a nap. She vociferously opposed biking with the dogs, so we took them for a walk around the neighborhood. Now, she’s cooking supper.
Typing hurts, so I will stop doing it.

Thoughts before carpel tunnel surgery

Not long ago, the anesthesiologist called about my surgery tomorrow. “You’ll be given two painkillers,” he said, “the first to kill the pain of the second until the second takes effect.” Drugs are funny. One doctor wrote me a prescription for Ambien recently. “This medication has been known, in rare cases, to cause violent behavior,” the packaging warned. A few days later another doctor gave me a prescription for Requip. “This drug has been known, in rare cases, to lead to compulsive gambling,” the packaging advised. “Oh, great,” I thought, “I’m going to be a violent gambler.”

Last night, I was too manic to sleep, so today I took a Vivarin. Since I don’t do caffeine anymore, an occasional Vivarin makes me really manic. I was that way when the anesthesiologist called, and was consequently so bubbly that I wondered whether I sounded drunk. After we hung-up, I went back to my yard work. As I crossed the backyard, I passed Bonnie walking the other way. “Hello, Bonnie,” I said. Then I remembered that Bonnie was in the front yard, and that the gate was latched. I thought that, well, maybe I just thought the gate was latched, so I went to check. It was latched. Things could be worse, I suppose. I could be hallucinating a dog that is dead or never existed.

I’ve spent days doing all the work around the house that I won’t be able to do during my convalescence. Last night, I baked crackers, biscuits, and cornbread. I actually started baking crackers two weeks ago because each batch takes two hours, and that’s if I don’t double it. I was raised on store-bought loaf bread, but my mother kept the larder stocked with homemade biscuits and cornbread. Of course, they were inferior to what I bake. I never use shortening—much less lard—or sugar, and all my breads contain several whole grain meals or flours. There are only two things that I love to cook. One is soup and the other bread; and of the two, I prefer bread. My father believed that whole grains were for hogs (he claimed that bleached flour was purer because it was white), so he was challenged to eat my bread when he came to live with us.

I am more nervous about this surgery than any I’ve had, because the ligament that the surgeon will cut is directly above the nerve that makes my hand function. I’ve thought about what it would be like to go through life with a purely decorative right hand, and whether the odds of that happening are small enough to justify the risk of surgery. I dealt with the issue by opting to stick with the decision I’ve already made, my thought being that I would need new information to back out with any integrity.

My hernia surgery (in January) was hours late, so I had a lot of time to lie on my stretcher and think. I really wanted to walk out of that place while I still could. I remembered my friend, Hulene (a woman after my own heart, her last act before surgery was to write me a letter), who died during hernia surgery five years ago. I also thought about my surgeon, and how I didn’t entirely trust him because he always seemed so harried. I finally reconciled myself to the fact that, having made the best decision I could, and having no new information that would justify a change of heart, I needed to trust the thinking I had done when I was less emotional. Even if it was wrong, it was the best I could do. This is what will make it possible for me to lie down upon yet another stretcher tomorrow. Meanwhile, I do dread the long night ahead.

Thoughts about supporting private and governmental evil

My neighbor, Ellie, also has carpal tunnel problems. Hers is advanced, so a return to normalcy is unlikely even with surgery, but Ellie is obliged to sell plasma just to get by, so surgery is out of the question.

One of my Masonic brethren, Nathan, changed jobs recently, and his new insurance wouldn’t take effect for ninety days. During that time, Nathan came down with an undiagnosed illness that caused his fever to hit 104º. He couldn’t afford a doctor, so he rode his illness out at home.

Linda, the technician who hooked me up to the monitors for my recent polysomnogram, was injured in an accident and unable to work for seven months. Her insurance ran out after six, leaving her $30,000 in debt.
I don’t look for such stories, but now that I have become so dependent upon insurance and so aware of how different my life would be without it, they leap out at me. It’s like never noticing a certain make of car until you buy one.

There is really no way around the fact that, as individuals and as a nation, we spend money on that which we value. I value financial security, so I save money. My sister-in-law values foreign travel, so she spends money on that even though she has to borrow against her house. As a country, we value the War in Iraq. We also value health care for poor people in other countries, although the money has to come partially from the taxes paid by the poor people in our own country, people who cannot afford health care. We say to our own poor that their lives are of less importance than countless other things that we spend money on. If Nathan should die or Ellie should become permanently disabled, well, that’s very sad to be sure, but Africans with AIDS need our help more, even if we are obliged to borrow the money from China.

I am amazed that we Americans put up with as much as we do, but then I am one of those by whom I am amazed. But what to do about it… I met a man last week who was going door-to-door to gather support for Barack Obama, and I wished mightily that there was a candidate who I believed in that much. Hell, I just wish I believed in the goodness of our democratic system that much.

“All voting is a sort of gaming, like checkers or backgammon, with a slight moral tinge…. I cast my vote, perchance, as I think right; but I am not vitally concerned that right should prevail. I am willing to leave it to the majority…. Even voting for the right is doing nothing for it. It is only expressing to men feebly your desire that it should prevail.” Thoreau

I have long admired Thoreau because he writes as if he were beside me, contemplating the same problem that I am contemplating. No matter that the steam engine was cutting edge technology in his day, his issues then are my issues now. Ah, but he knew what to do about them. He avoided marriage partially because marriage would make moral compromise easier, but I embraced marriage because I had yet to meet the issues, and because I naively thought I could have it all. Still, I would not choose to live alone. But what would I do differently if I were alone? I would bury my money in a hole in the ground (figuratively or literally), so the IRS couldn’t find it, and I would stay in Oregon most of the year so I wouldn’t have to pay a sales tax. I feel little compunction to eradicate evil, but a great compunction to abstain from supporting it.

Yesterday, I received a bill for $465 for the carpal tunnel surgery that I haven’t had yet. The letter explained that this should cover my portion—after insurance—of the clinic’s operating room. This means that the clinic is going to charge $2,325 for the half hour that I will spend in that room. If not for the insurance company’s required write-off, the charge would be closer to $3,000. The letter also explained that the surgeon and anesthesiologist will bill me separately.

Last night, I could scarcely sleep for knowing that I am supporting a merciless and avaricious health care system. During one of the short lulls in my wakefulness, I dreamed that I was required, before surgery on Friday, to pay $499.99 in advance for a bath in a stainless steel tub. The tub turned out to be a thin vinyl mattress that was painted to look like stainless steel, and the bath was a damp washcloth with which I was told to wipe myself off.

My father died partially because he was unwilling to support what he considered a greedy healthcare system. People generally thought he was a nutty eccentric, but, for what it’s worth, Thoreau would have made the same choice. Of course, people in Thoreau’s day thought he was a nutty eccentric too. People who won’t support evil no matter what the cost to themselves are ever seen in such a light.

I look at things this way. My wrist hurts and my hand tingles. I sleep in a brace. I avoid certain activities. I am guardedly optimistic that surgery will change all this. On the other hand, if I refuse the surgery, what good will I have accomplished? None, externally. But would I respect myself more? Maybe, but I am still going to put my money into surgery, because I value my health more than I value my own moral approval, especially in regard to a decision that won’t make the world better or worse anyway. How do I live with this choice? I tell myself that the surgery will soon be over, and that I will move on. I usually prize expediency above principal, and I feel bad about this at times, and not so bad at other times. Mostly, I try not to think about it. In fairness to myself, those around me seem to knuckle under more than I do. They just ponder it less.

practically a doctor a day

This has been a doctor week. Yesterday, I saw an orthopedist whose specializes in hands, wrists, and elbows; today, an orthopedist who works on shoulders. Before them, a sleep specialist. I resist being the kind of person who runs to the doctor for every little thing, and I indeed considered canceling at least one of my appointments on that basis alone. But, the thing is, I don’t run to doctors for every little thing. I’ve had sleep problems for ten years, carpel tunnel for twenty, shoulder pains for eighteen months. I’ve put in my time studying—and sometimes trying—self-treatments and alternative treatments, yet I have only gotten worse.

I usually have a tentative diagnosis for a problem, and know everything medicine can do for it before I even see a doctor. I try to keep emotion out of doctor visits, because doctors are at their best when they feel they have something to offer, and few have much to offer in the way of emotional support.

The longer the appointment, the more of a challenge emotional neutrality becomes, and I might not know I’ve lost it until I realize I missed several sentences or failed to understand simple statements. Peggy and I try to go with one another to the doctor to compensate for such deficiencies.

I originally went with her—at her request—to offer moral support, and I usually didn’t ask her go with me because I didn’t think I needed moral support. I’ve discovered, though, that what I do need is another clear head in the room. She takes me with her for an additional reason. She is convinced that doctors—both male and female—treat her better when she’s with a man.

She and I both hold doctors in low esteem until they give us reason to think otherwise. Her nursing experiences have soured her, whereas I react more to the deference they expect and to the exorbitant fees they charge. They’re also typically rushed and, to many of them, medicine is simply a way to earn money. Then there are the limitations of medicine itself.

If a doctor comes into the room and says, “Mr. Thomas, I am Doctor Boneshaker,” he or she loses five points. If he shook hands as he said it, he only loses two points. If he gives his full name (giving me the option of what to call him), he gains five points.

I am often tempted to say, “I don’t do deference. I can call you Bill, or I can call you Mr. Boneshaker, or I can not call you anything. You choose.” I don’t say this because it might arouse hostility, and hostility would inhibit the doctor’s ability to help me. It’s one of those predicaments for which I can find no good solution.

I often run into more interesting problems with doctors. Both my hernia surgeon and the hand surgeon I saw yesterday (for carpel tunnel surgery) proposed the last surgical option that I had expected based upon my research. Every website I visited recommended endoscopic surgery over an open incision for hernia surgery, yet my doctor recommended an open incision based upon my thin build. The hand surgeon had even more treatment options—four in all—yet he chose one-hole endoscopic, the very surgery that has the highest failure rate.

How is a patient to respond? I fall back upon my overall impression of the doctor. Does he seem to care? Did he take the time to explain his reasoning? Is his resume impressive? The hand surgeon explained the discrepancy between my reading and his own approach this way. (1) Less qualified surgeons negatively skew the results. (2) Many websites lean toward conservatism because they are collectively produced across many disciplines, and because a wide range of surgical candidates look to them for advice. His patience in addressing my concern impressed me and that, along with his reasoning and his other qualifications, made me decide to go with his recommendation.

His description of the level of care my wrist I would need after surgery was far more optimistic than what I had read. For example, the Mayo Clinic advised that I not even lift a jug of milk for the first two weeks, whereas he told me to let my comfort level be my guide. When I asked about the discrepancy, he said that Mayo’s advice was based partly upon what he considered outmoded surgical techniques, and that tissue damage from a single puncture would be much less than that from a four-inch incision. That made sense. Whether it’s true, I don’t know. I could consult one or two more surgeons and go with the consensus, but I waited ten weeks to see this one, and this is an extremely common surgery, and it is also his bread and butter.

The amount of caution that is warranted in a surgical undertaking becomes much clearer in retrospect. My knee surgery was a mistake, but I undertook what I considered a prudent amount of research going into it, and I didn’t learn until later that the surgery plus physical therapy is no better than physical therapy alone. But that was two years ago, and I have come far in the amount of trouble I am willing to go to on my own behalf.

I can see how doctors would come to resent all the hours they spend explaining why they disagree with Web MD, but I should think that a patient would have to be pretty naïve to want to remain ignorant. Of course, I might be leaning too far in the other direction. I took complete control of my discussion with the hand surgeon yesterday, and, after I had gotten all of my questions answered and verified the Peggy had gotten all her questions answered, we left without either of us asking the surgeon if he had anything to say. In an ideal world, we wouldn’t need to ask, but I try to look at things from the doctor’s viewpoint.

Yesterday, for example, the doctor tried to take the initiative, but sensing that I knew where I wanted to go—and that I needed to feel in control—he backed off. I later wondered if he didn’t go so far as to stop thinking proactively, allowing himself to become simply a resource for answering questions. I quickly consoled myself with my observation that I have never found surgeons to be a timid species who readily allow themselves to be trodden upon.

My shoulder appointment this morning did not have a happy outcome. I thought I had lingering tendon inflammation from yoga exercises two years ago, but the x-rays showed jagged arthritic damage in both shoulders. The doctor advised that I avoid weight-bearing activities if I want the joints to last. When I asked how she was able to rule out soft tissue injuries, she said she wasn’t, but that there isn’t much she can do about them short of surgery, and I’m hardly ready for that. The best she could offer was an appointment with a physical therapist, and I took her up on it.

Sleeplessness

Last week, I repeatedly mistook the same chair for Bonnie, and I heard voices coming from a radio that was unplugged; both no doubt due to a lack of REM sleep. When the insomnia first hit me, I lay in bed longer to catch-up on my sleep. My back soon hurt so bad that I couldn’t lie on it, yet I couldn’t lie on my sides or my stomach either due to the tendonitis in both shoulders. What sleep I did get was interrupted by dreams of suffocating in airless rooms, suffering cyanide related seizures in a Nazi death chamber, or vomiting due to exhaust fumes. I have never faced a more dismal prospect than that of finding sleep and wakefulness equally impossible. I realized that there was a limit to how long I could hold up either psychologically or physically, yet the prospect of leaving Peggy by my own hand seemed equally cheerless.

I have gone to a lot of trouble and expense (including two surgeries) over the past ten years in an effort to remedy my sleep problems, yet they have grown increasingly worse. The only advantage I have found in such things is that they allow me to make a more accurate appraisal of human frailty. People who have not known sickness cannot know how tenuous health is, yet it is knowledge worth having. I read the thoughts of the benefactors of my species, and I contemplate the extent upon which their thoughts were based upon such things as trace minerals and sleep, things that they so often despised. How ungrateful the man who loathes that upon which his every thought depends.

I bike to get Wittgenstein, his misery contrasted with Hume's happiness

I biked to the library in the rain this morning just to get Wittgenstein’s Philosophical Investigations. I had avoided Wittgenstein because I knew enough about him to know that he dismissed most of the questions that are asked by philosophers as nonsensical, and I didn’t want this to be the case because, nonsensical or not, they are questions I cannot avoid. He wrote:

“People say again and again that philosophy doesn’t really progress, that we are still occupied with the same philosophical questions as were the Greeks. But the people who say that don’t understand why this has to be so. It is because our language has remained the same and keeps seducing us into asking the same questions.”

Okay, great. I can even imagine him to be right, but—and this is another reason I avoided Wittgenstein—the man was suicidal. When he finally learned that he had terminal cancer—at about the same age I am now—he didn’t even care, because as he put it: “I have no desire to live.”

But the skeptic in me might well ask: “But how do you know that his despair was the necessary outcome of his philosophy?” Well, I don’t. David Hume was the most renowned skeptic of all time. He could abolish claims to knowledge as adroitly as a man with a machine gun could abolish chickens, yet he was a happy man, and as he approached death, he remained that way. He even wrote that he had no idea why one with such a dismal philosophy could be so happy, and concluded that it must simply be congenital. Go figure. Surely, nothing is good or bad unless what our thinking makes it so, but what makes our thinking make it so? Optimists say that we are free to choose, but I think they give themselves too much credit. They say “Be like us” in the easy certainty that they too could be jaded, cynical, and pessimistic if they so pleased.