(excerpt from “It’s Not All About You,” c. 2015, Trey Casimir L.Ac.
Abuse from a loved one creates scars that maybe never heal. This is not something we do to ourselves, but something that is done to us by others, and its effects don’t stop just because no one is currently trying to physically or emotionally hurt you. With the epidemic of narcissism that seems to be sweeping our civilization, such abuse can only increase, as more and more people look out for themselves first, second and third, without regard for how their actions affect the people around them.
Now, there’s a difficult thing about abuse, and I only offer this controversial and upsetting idea because I myself have been affected by abuse, and have only recently become aware of its continuing reverberations in my spirit. That difficult idea is this: Is it sometimes possible that a person is “asking for it?” I don’t mean that any infant is ever asking to be injured, or that any woman is ever fair game for sexual crime because she is attractively or provocatively dressed. Rather, writing as a person with abuse in my past, one of the painful reverberations in my life has been that I have tended to seek out, or at least to be attracted to, people who turn out to be abusive. Was I therefore “asking for more abuse?” I would say, “Of course not!” and would offer my tears and horror at this self-discovery as proof that I wasn’t consciously looking to be abused. However, there is anecdotal evidence suggesting some sort of correlation.
In my own case, two thoughts present themselves. First of all, I loved my first abuser and looked up to him, no question about it. That’s why his hatred and murderous intent hurt me so much, never mind the concussions, stitches and other physical injuries. I never got his love in return, but that doesn’t mean he was unlovable. That I might seek people out who in some way remind me of my abuser, so I can finally get what I was denied – love – makes a kind of sense to me. That people who remind me of my abuser might turn out to be abusive themselves also makes a kind of sense to me. On an entirely other hand, though, is the unconscious signs an abused person might display. In my case, and in some others who I have treated, the left shoulder is especially likely to be injured, tense or otherwise held in a “cocked” position. Imagine that someone is about to hit you in the ear, and you’ll feel this unconscious defensive posture. It could be the other shoulder or some other body part (people who have suffered sexual abuse sometimes have over-developed and slightly turned in thighs), but our bodies plainly carry residue from past trauma, whether physical, psychological or spiritual. Most energetic medicine is based on this assumption – “body/mind/spirit” is a phrase that articulates this idea, among others.
So there I am, with my cocked shoulder, going into a group of people. Like a pheromone or other unconscious signal, what if the posture of the abused person is understood by the herd? What if abusers are particularly adept at spotting the signs of past abuse? And what if I am still afraid/angry/ashamed/hurt at a very deep level, and am eager to compensate or maybe over-compensate for my past trauma? Like a nerd playing tackle football with the popular jocks, no one has to be at fault – there needn’t be an abusive intent – yet we all know that nerd is going down. And if I target the person who reminds me of my abuser, whose love I still long for, it is that much more likely that I’ll go down hard. In acupuncture terms, this shoulder hunching reflex is associated with warding off the wind or other external pathogens. Although the ancient Chinese weren’t referring to abusive people, but rather to climatic factors, an attacker certainly qualifies as an external pathogen. Many people who have hyper-sensitive or even auto-immune problems turn out to have been previously abused. With no other specific risk factor or clear vector for infection (say, shared needles for HIV), why wouldn’t a person with unconscious hyper-reactivity to a past abuser continue to carry hyper reactive defenses forward in all realms of their existence, including their unconscious immune systems?
More troubling, perhaps, is the combination of Yin and Yang Qiao Mai as an acupuncture treatment. The Yang Qiao Mai addresses weight (obligation, responsibility) that the world puts on your shoulders, while the Yin Qiao Mai addresses weight that you put on your own shoulders. Frequently it happens (especially with mothers, healthcare providers, teachers and caretakers) that the world puts weight on a person and they respond by putting more pressure on themselves ("I thought so – I wasn’t working hard enough”). This dynamic can be very effectively addressed by treating Yang Qiao Mai primarily and Yin Qiao Mai secondarily. However, occasionally it happens (based on various other diagnostic criteria), that the Yin Qiao Mai is primarily affected and the Yang Qiao Mai is secondary. That is, you put too much pressure on yourself and the world responds by putting more pressure on you. The first time I made such a diagnosis I was very apprehensive about explaining the dynamic to my patient, because it sounded like I was saying, “You brought this problem on yourself.” To my surprise, though, she immediately said, “Oh, my god. That’s exactly what I’ve been working on with my therapist for a long time!” As I recall, the treatment was very helpful, which is additional evidence that there was something to this dynamic for this person. One could see, perhaps, that people who are hard on themselves get a lot done, and “if you want to get it done, give it to a busy person,” or the like, but especially where abuse exists it is vital to keep the blame where it belongs – with the abuser and those who didn’t protect against the abuse. So this Yin and Yang Qiao Mai thing makes one very uneasy.
However, one of the physical attributes that accompanies Yin Qiao Mai dysfunction is that the arms and legs turn in – in other words, the thighs turn in (as has been noted after sexual abuse), and the shoulders hunch (as has been noted in other forms of physical abuse). Maybe these unconscious, physical/postural signs read like a red blossom to a hummingbird for abusers. Again, we have an external influence (the original abuse) causing an internal response (fear/anger/shame/hurt). Furthermore, this internal response results in an external posture that may act to attract abusers! Makes one wonder about the evolutionary advantage of such an interplay, but in any event, abuse offers another clear window through which to see the impact an external influence can have on the internal workings of a person, to such an extent that the internal workings percolate through to become manifest on the exterior of the abused person.
To be clear, this is pathological, and is not role-playing or S & M game-playing. I feel the need
to add this because I have had abusive people tell me, “You must be a masochist,” or even, “You must like it,” in regard to my history with abuse and abusers. But this is not the simple story of a cute molecule settling into the right-shaped receptor – rather, it is the story of a cute molecule that has been brutally altered to fit into a shape that is recognized by other brutes.
Thursday, October 22, 2015
Monday, September 28, 2015
Letting go
The Chinese say that Fall is the season of grief, but it's also the season of letting go. As I have previously confessed, I don't do so well with this season, and a lot has to do with the difficulty of letting go. It means such different things in different settings, and it's hard to tell from the inside if one is making a fair and reasonable decision or just being selfish. Case in point: I resigned from the last of my volunteer positions in local government a couple weeks ago. On one hand, I feel bad about leaving my friends (and the trees and the fire company) in the lurch. On the other hand, I have donated ten years to working for the Borough through being an elected official and participating in various committees, study groups, etc. I am confident that I have done some good, and I continue to be vitally interested in the goings-on in my hometown. However, there's a bottom line. After practicing acupuncture for 15 years and exercise therapy for more than 25, I am still having a hard time making a living. I don't feel like a failure, but I do need to do something different to supplement the income I make as an acupuncturist. Therefore, I've had to let go of my cherished volunteer work so I can re-direct my focus on making my family more financially secure. Everyone understands, but there are still people who are disappointed in me or who have hurt feelings. So it's hard -- we don't live in a vacuum, and when I let go of something that may require someone else to pick it up. At the end of the day, all one can say is, "Sorry, It's someone else's turn."
On still another hand, letting go is necessary to move on, including to grow and mature. I have always had a hard time with this -- supposedly this is part of being a baby-boomer, but I have frequently needed to be "kicked upstairs" in my personal and professional life. I wish I was smoother at this life skill, because I hate being kicked and others hate kicking me, but it seems to be part of my karma. I am very loyal, and I have a great ability to endure when others would pack it in. Those are strengths, but it is a weakness to not let go until my survival is threatened. As a result, there are a few sinking ships in my wake, with angry people saying I abandoned them. Well, I WAS born in the Year of the Rat!
Short of survival, though, other things should motivate us to let go, and this seems to be one of the great life lessons I must learn. Among other things, sometimes one ends up in situations that are simply inappropriate, and that reflect poorly on one's sense of self-worth or self-esteem. I'm not talking about having a nice car to drive or fancy boots, but feeling like ones life has a purpose and like one is contributing something by doing his best. I love what I do, and I think I'm pretty good at it. I'm also proud of the practice I have been able to build in this small town, and I am grateful to the people who trusted me with even a part of their health care. But something has to give. In struggling with this over the years and especially as the summer of 2015 has come to a close, I have realized that my strength to endure and my inclination to loyalty sometimes makes me appear unambitious or insecure. Nothing could be further from the truth. In fact, my first life lesson was to overcome the surplus of over-confidence that I was born with by dedicating myself to serving others. But I tend to go overboard in all things -- well, I WAS born in the State of Texas!
Professionally, I realized that I have been generous to a fault with my practice. I have always given discounts to seniors, students and some other groups of patients, and will continue to do so. However, I have pretty consistently given away 20% of my fees over the past fifteen years, and I can't afford that. When I first started, I was very reasonably concerned about my ability to attract and keep patients. Being unwilling to manipulate the desperate people who came to see me for more visits and more fees, I instead tried to attract as many people as possible to my practice, and discounted service was one way to do that. However, I've been doing this for fifteen years now -- I'm pretty good at it and my reputation is excellent. At this point in my career, the extent of the discounts I offer doesn't only leave my bank account thin, but also under-values the service that I provide to my patients. For both of these reasons, I am going to be more judicious in offering discounts going forward. I will continue to honor the specific discounts I have negotiated with individual, long-time patients, but I won't be offering standard discounts with my newsletter, and I may trim some of the other policies I have followed for the last fifteen years. Like my volunteer service, I'm going to have let go of some of that. Otherwise, I'll have to find another job. I don't want to do that, and I don't think my patients want me to do that.
In any event, difficult, scary and unpleasant as it is, I'm letting go of some of my generous impulse in professional situations. I want to be here for a long time, providing first-rate acupuncture and exercise therapy to the community. I don't want to become one of those places that people sigh about and say, "Remember when..? I wonder why he went out of business..." I'm letting go of one thing (my insecurity about bringing acupuncture and yoga-based exercise therapy to Central PA) so that I can hold more tightly to the more important thing (supporting my family by providing first-rate acupuncture and exercise therapy to the community for the rest of my career).
Strange how "letting go" works out sometimes.
On still another hand, letting go is necessary to move on, including to grow and mature. I have always had a hard time with this -- supposedly this is part of being a baby-boomer, but I have frequently needed to be "kicked upstairs" in my personal and professional life. I wish I was smoother at this life skill, because I hate being kicked and others hate kicking me, but it seems to be part of my karma. I am very loyal, and I have a great ability to endure when others would pack it in. Those are strengths, but it is a weakness to not let go until my survival is threatened. As a result, there are a few sinking ships in my wake, with angry people saying I abandoned them. Well, I WAS born in the Year of the Rat!
Short of survival, though, other things should motivate us to let go, and this seems to be one of the great life lessons I must learn. Among other things, sometimes one ends up in situations that are simply inappropriate, and that reflect poorly on one's sense of self-worth or self-esteem. I'm not talking about having a nice car to drive or fancy boots, but feeling like ones life has a purpose and like one is contributing something by doing his best. I love what I do, and I think I'm pretty good at it. I'm also proud of the practice I have been able to build in this small town, and I am grateful to the people who trusted me with even a part of their health care. But something has to give. In struggling with this over the years and especially as the summer of 2015 has come to a close, I have realized that my strength to endure and my inclination to loyalty sometimes makes me appear unambitious or insecure. Nothing could be further from the truth. In fact, my first life lesson was to overcome the surplus of over-confidence that I was born with by dedicating myself to serving others. But I tend to go overboard in all things -- well, I WAS born in the State of Texas!
Professionally, I realized that I have been generous to a fault with my practice. I have always given discounts to seniors, students and some other groups of patients, and will continue to do so. However, I have pretty consistently given away 20% of my fees over the past fifteen years, and I can't afford that. When I first started, I was very reasonably concerned about my ability to attract and keep patients. Being unwilling to manipulate the desperate people who came to see me for more visits and more fees, I instead tried to attract as many people as possible to my practice, and discounted service was one way to do that. However, I've been doing this for fifteen years now -- I'm pretty good at it and my reputation is excellent. At this point in my career, the extent of the discounts I offer doesn't only leave my bank account thin, but also under-values the service that I provide to my patients. For both of these reasons, I am going to be more judicious in offering discounts going forward. I will continue to honor the specific discounts I have negotiated with individual, long-time patients, but I won't be offering standard discounts with my newsletter, and I may trim some of the other policies I have followed for the last fifteen years. Like my volunteer service, I'm going to have let go of some of that. Otherwise, I'll have to find another job. I don't want to do that, and I don't think my patients want me to do that.
In any event, difficult, scary and unpleasant as it is, I'm letting go of some of my generous impulse in professional situations. I want to be here for a long time, providing first-rate acupuncture and exercise therapy to the community. I don't want to become one of those places that people sigh about and say, "Remember when..? I wonder why he went out of business..." I'm letting go of one thing (my insecurity about bringing acupuncture and yoga-based exercise therapy to Central PA) so that I can hold more tightly to the more important thing (supporting my family by providing first-rate acupuncture and exercise therapy to the community for the rest of my career).
Strange how "letting go" works out sometimes.
Tuesday, September 30, 2014
Science as the Final Authority
This morning there was an interesting interview on NPR with the author of a new book about vaccinations. The interview can be read or heard here: http://www.npr.org/blogs/health/2014/09/30/351242264/vaccine-controversies-are-as-social-as-they-are-medical
The comments on the npr.org website are also very interesting. Below is my contribution to the discussion.
I listened very intently to the interview today with Eula Biss regarding her new book, "On Immunity," regarding vaccination. I, too, am a parent, and I have also had questions about vaccination, on all sides of the question. I agree with Ms. Biss in her borrowed observation that “when you split the difference between information and misinformation, you still end up with disinformation.” However, maybe it is a shortcoming of vocabulary, but the only alternative to “information” is not "disinformation.” Where does “anecdotal evidence” fall in this spectrum? How about “wisdom?” Although I was raised to be a scientist, an intellectual and a skeptic, these approaches alone proved insufficient for fully understanding and managing my life, and I eventually branched out and became a practitioner of breath-centered exercise therapy and an acupuncturist. Some would say this puts me on the side of “disinformation” -- although I would beg to differ, classical Chinese medicine is certainly not scientific medicine, and I'm fine with that.
Ms. Biss blames some of people’s reluctance to vaccinate on a “distrust of the government,” but some people also distrust science, and especially scientific medicine. I myself believe in the scientific method, but scientific medicine is another matter. First of all, when the scientific paradigm shifts, everything that used to be true becomes untrue. This is so patently false that people turn away from, say, the latest scientific advice about a healthy diet, simply because the “truth” is constantly shifting. More aggravating to me, though, as someone whose profession and personal integrity are regularly assailed by people on “scientific” grounds, is the casualness with which even respected and experienced scientists apply the scientific method. As it happens, Ms. Biss employs this same casualness in her own approach to vaccination. In the interview she said, after much rational discussion about the science, economics and politics of vaccinations:
“I would prefer for my son to have as little medical care as possible, as little contact with the medical system as possible. I think vaccination is actually one way to try to help ensure that — making sure that he doesn't get something like pneumonia that might mean a hospital stay, where things will be done to him that will make me uncomfortable or that he will be treated in a way that might feel excessive to me. I think the best way for me to keep him out of that system is to engage in this highly effective preventative medicine.”
I can’t tell you how many people have told me, “I hate pills.” Well, I understand why they feel that way, but it’s an uninformed (or half-formed) and ultimately unconstructive point of view, because sometimes pills will save your life, or make your life better. This is essentially the same thing that Ms. Biss has said regarding her son. Because she fears (or dislikes, or distrusts, or otherwise has a negative opinion of) the “medical system,” she will “only take one” of that system’s strategies in order to avoid using its other recommendations and practices. Never mind that a hospital stay can save her son’s life, she will take this other step, that she can comprehend and that she believes has minimal risk, because she fears the experience of having a child in the hospital. In other words, Ms. Biss’ use of vaccinations for her child is an act of faith, based on her fear of hospitals and the rest of the “medical system.” This is a mother’s prerogative, but it certainly isn’t scientific.
As a body mind spirit practitioner, I have no problem with acts of faith, but I do think you should have some self-awareness, some understanding of how you are living your life and why you are making the choices you make. As a professional whose profession is under frequent attack by proponents of scientific medicine, I don’t feel so generous. If you are going to put all non-scientific points of view on a different and lower level than your own rational, scientific point of view, then have the courage of your convictions and be scientific! And if you are going to occasionally indulge in faith or emotion during a scientific discussion, please understand that this lapse blows your claims of rational, scientific impartiality clean out of the water. You can’t cherry pick the science that appeals to you – you either employ the scientific method in your approach, or you do not.
As it turns out, we are not capable of being purely rational, nor is it desirable – that’s the comic, ironic and profound point of characters such as Mr. Spock on Star Trek, and Sheldon Cooper on The Big Bang Theory. Again, I don’t have a problem with irrational behavior, but I do have a problem with those who castigate, judge or hold themselves superior to others based on the critics’ self-identification as “rational” or “scientific.” The truth of things is that there are many things we don’t understand, as patients and as practitioners, no matter how rational we are. We have to live with that ignorance, but still make the best, most well-informed and most prudent decisions we can about caring for our health, or helping others care for their health. These are not usually black and white decisions, as scientific medicine would sometimes have us believe, but shades of grey decisions, just like the rest of life’s decisions. How do you choose a spouse? Some of it is rational, and some of it is purely feel, smell, touch, instinct, mythology...
In our society, people don’t want to think about many, many things. They don’t want to think about racial inequality, gender inequality, income inequality, the Middle East, the environment… and they don’t want to think about their health. The truth is that you must engage with the world – disengagement is fatal to life. Where your health is concerned, you must keep your critical mind working at every step of the process, even though you may never arrive at “the answer.” Otherwise, you find yourself with a big surprise, a collapse of the paradigm, if you will, after which the vast majority of us become passive recipients of health care, and the scenario that Ms. Biss most fears plays itself out, like a self-fulfilling prophecy. I think it is more useful, when discussing health matters, to encourage engagement and critical thinking while accepting that some decisions will be made on other grounds – faith in the practitioner, your family’s individual needs, a close friend or family member’s experience, or just a gut feeling. Promoting either/or, black and white thinking is unrealistic in this three dimensional world we inhabit, and is unfair to people making difficult yet conscientious decisions about their or their family members’ health. Putting all your faith in “science” or “reason” is no guarantee that you will dodge the reaper, and like all magical thinking, that faith is bound to come undone at some point, when it conflicts with reality. Better to use all your human faculties, among them reason, when making such an important decision as choosing a spouse or choosing a healthcare strategy or practitioner.
By way of full disclosure, my wife and I decided to vaccinate our three sons with every vaccine that has been on the market for at least 15 years. This should help protect them from many known threats, assuages our consciences on the public health front, and perhaps avoids the dangers that can come from diving into new and as yet unproven scientific paradigms. But I consider our actions in this regard to be as much a matter of faith as of reason.
The comments on the npr.org website are also very interesting. Below is my contribution to the discussion.
I listened very intently to the interview today with Eula Biss regarding her new book, "On Immunity," regarding vaccination. I, too, am a parent, and I have also had questions about vaccination, on all sides of the question. I agree with Ms. Biss in her borrowed observation that “when you split the difference between information and misinformation, you still end up with disinformation.” However, maybe it is a shortcoming of vocabulary, but the only alternative to “information” is not "disinformation.” Where does “anecdotal evidence” fall in this spectrum? How about “wisdom?” Although I was raised to be a scientist, an intellectual and a skeptic, these approaches alone proved insufficient for fully understanding and managing my life, and I eventually branched out and became a practitioner of breath-centered exercise therapy and an acupuncturist. Some would say this puts me on the side of “disinformation” -- although I would beg to differ, classical Chinese medicine is certainly not scientific medicine, and I'm fine with that.
Ms. Biss blames some of people’s reluctance to vaccinate on a “distrust of the government,” but some people also distrust science, and especially scientific medicine. I myself believe in the scientific method, but scientific medicine is another matter. First of all, when the scientific paradigm shifts, everything that used to be true becomes untrue. This is so patently false that people turn away from, say, the latest scientific advice about a healthy diet, simply because the “truth” is constantly shifting. More aggravating to me, though, as someone whose profession and personal integrity are regularly assailed by people on “scientific” grounds, is the casualness with which even respected and experienced scientists apply the scientific method. As it happens, Ms. Biss employs this same casualness in her own approach to vaccination. In the interview she said, after much rational discussion about the science, economics and politics of vaccinations:
“I would prefer for my son to have as little medical care as possible, as little contact with the medical system as possible. I think vaccination is actually one way to try to help ensure that — making sure that he doesn't get something like pneumonia that might mean a hospital stay, where things will be done to him that will make me uncomfortable or that he will be treated in a way that might feel excessive to me. I think the best way for me to keep him out of that system is to engage in this highly effective preventative medicine.”
I can’t tell you how many people have told me, “I hate pills.” Well, I understand why they feel that way, but it’s an uninformed (or half-formed) and ultimately unconstructive point of view, because sometimes pills will save your life, or make your life better. This is essentially the same thing that Ms. Biss has said regarding her son. Because she fears (or dislikes, or distrusts, or otherwise has a negative opinion of) the “medical system,” she will “only take one” of that system’s strategies in order to avoid using its other recommendations and practices. Never mind that a hospital stay can save her son’s life, she will take this other step, that she can comprehend and that she believes has minimal risk, because she fears the experience of having a child in the hospital. In other words, Ms. Biss’ use of vaccinations for her child is an act of faith, based on her fear of hospitals and the rest of the “medical system.” This is a mother’s prerogative, but it certainly isn’t scientific.
As a body mind spirit practitioner, I have no problem with acts of faith, but I do think you should have some self-awareness, some understanding of how you are living your life and why you are making the choices you make. As a professional whose profession is under frequent attack by proponents of scientific medicine, I don’t feel so generous. If you are going to put all non-scientific points of view on a different and lower level than your own rational, scientific point of view, then have the courage of your convictions and be scientific! And if you are going to occasionally indulge in faith or emotion during a scientific discussion, please understand that this lapse blows your claims of rational, scientific impartiality clean out of the water. You can’t cherry pick the science that appeals to you – you either employ the scientific method in your approach, or you do not.
As it turns out, we are not capable of being purely rational, nor is it desirable – that’s the comic, ironic and profound point of characters such as Mr. Spock on Star Trek, and Sheldon Cooper on The Big Bang Theory. Again, I don’t have a problem with irrational behavior, but I do have a problem with those who castigate, judge or hold themselves superior to others based on the critics’ self-identification as “rational” or “scientific.” The truth of things is that there are many things we don’t understand, as patients and as practitioners, no matter how rational we are. We have to live with that ignorance, but still make the best, most well-informed and most prudent decisions we can about caring for our health, or helping others care for their health. These are not usually black and white decisions, as scientific medicine would sometimes have us believe, but shades of grey decisions, just like the rest of life’s decisions. How do you choose a spouse? Some of it is rational, and some of it is purely feel, smell, touch, instinct, mythology...
In our society, people don’t want to think about many, many things. They don’t want to think about racial inequality, gender inequality, income inequality, the Middle East, the environment… and they don’t want to think about their health. The truth is that you must engage with the world – disengagement is fatal to life. Where your health is concerned, you must keep your critical mind working at every step of the process, even though you may never arrive at “the answer.” Otherwise, you find yourself with a big surprise, a collapse of the paradigm, if you will, after which the vast majority of us become passive recipients of health care, and the scenario that Ms. Biss most fears plays itself out, like a self-fulfilling prophecy. I think it is more useful, when discussing health matters, to encourage engagement and critical thinking while accepting that some decisions will be made on other grounds – faith in the practitioner, your family’s individual needs, a close friend or family member’s experience, or just a gut feeling. Promoting either/or, black and white thinking is unrealistic in this three dimensional world we inhabit, and is unfair to people making difficult yet conscientious decisions about their or their family members’ health. Putting all your faith in “science” or “reason” is no guarantee that you will dodge the reaper, and like all magical thinking, that faith is bound to come undone at some point, when it conflicts with reality. Better to use all your human faculties, among them reason, when making such an important decision as choosing a spouse or choosing a healthcare strategy or practitioner.
By way of full disclosure, my wife and I decided to vaccinate our three sons with every vaccine that has been on the market for at least 15 years. This should help protect them from many known threats, assuages our consciences on the public health front, and perhaps avoids the dangers that can come from diving into new and as yet unproven scientific paradigms. But I consider our actions in this regard to be as much a matter of faith as of reason.
Tuesday, September 16, 2014
Panic
It's been an alarming time recently. New instability in the Middle East, new confrontations with Russia and new outbreaks of Ebola in Africa. Continued economic hard times, racial injustice and high profile domestic violence here at home. What's an American acupuncturist to do? All the experts say: "Market! Market! Market! Now is the ideal time to take advantage of your patients' fears and worries to sell them on the calming powers of acupuncture!" While it is true that acupuncture can be a great help to people in times of stress, whether extreme trauma (on the battlefield) or quiet desperation (at the dinner table and in the bedroom), it has always seemed despicable to me to take advantage of people when they are at their most vulnerable. Just because I, too, am feeling lots of stress doesn't justify abandoning my principles to take advantage of others.
There was a horrifying sequence of items on the radio this morning. The first dealt with the rise in the incidence of people's wages being garnished and bank accounts being cleaned out by debt collectors, many times due to medical debt. The next story dealt with 2500 authors who have contracts with Hachette Book Group -- Hachette and Amazon are in some sort of corporate feud, so Amazon is making it hard for people to buy these authors' books. Because sales have dropped for some of these writers by 90%, they have gone to Amazon's Board of Directors to try to get some relief, but the response so far has been to say that the authors are "naive." The final story addressed the horrible and sad killing of John Crawford, a young African-American man who was recently shot and killed by two policemen in a Walmart because he was carrying a BB gun... which he had taken off the shelf at the Walmart in order to buy it. I guess I'm naive, too. All of these things seem so completely unfair, but not only that, they seem to be actively anti-life -- like social Ebola. The debt collectors get their vig, Amazon makes a few more percentage points of profit, and the terrified beneficiaries of slavery get to neutralize another dangerous black man. But when no one has any money left, when no authors will bother writing books, and when the African-American community realizes that non-violent civil disobedience isn't working in the 21st century, where will we be then? The current state of haves and have-nots will seem like a golden age compared to the walled compounds that the haves will need and the criminal societies that the have-nots will create if things keep moving in their current direction.
Since this is a blog about acupuncture and I try to stick to that subject, this period reminds me a bit of the Warring States period in Chinese history. For about 250 years, beginning around 475 B.C., there was almost constant war between the different regions and clans of China. In the end, the strongest clan started the modern era of dynasties, but it was as much a result of the exhaustion of all the other states as it was the superiority of this one group that led, finally, to this extended period of "peace." The main accomplishment of all this fighting was the consolidation of centralized political power, but that centralized power belonged to whoever could seize it. So in a way the wars were just more formalized and ritualized -- less peasant blood was spilled on the battlefield, perhaps, but the same few rich and powerful families continued to scheme over who was going to run China. This is where, hopefully, China's story and America's would diverge. We are a democratic republic, not an aristocratic empire, so feuding between the states followed by scheming for control between a few rich and powerful families shouldn't be how our story plays out... should it? I have to say, I don't know. We all know the names of the families, first in the Gilded Age (Rockefeller, Carnegie, Mellon, Astor, Morgan, Roosevelt), then through the mid-century (Koch, Kennedy, Schwab, Hilton, Vanderbilt) and into the modern day (Gates, Trump, Buffett, Harriman, Duke). Maybe it is a natural law that the wealthy and powerful will rise to a more and more dominant position in any society -- I just don't know. But perhaps this is more heart-breaking in a society that is rooted in idealistic and egalitarian concepts such as liberty, justice and the pursuit of happiness.
In any event, back to the question: What's an American acupuncturist to do? I have been as panicked as anyone, and I don't usually panic. But a combination of stresses reduced me to tearful feelings of despondency and worthlessness last weekend. Where's the money going to come from for my family to survive, never mind thrive? What will become of my children? Will my wife and I ever again get to travel, see or make art or otherwise enjoy ourselves? How will we survive old age if I become unable to work before I quickly, conveniently and painlessly die? And if I, a well-educated son of middle class white American privilege am having it this tough, what about all the people in the country and in the world who don't have my advantages? How can I or anyone else expect the less fortunate to simply lie down and accept their lack of a future and the total lack of any hope for their advancement? Why wouldn't my unhappy neighbors on welfare (or a bunch of destitute refugees from [name your country]) decide to get some weapons and come try to take our homes and belongings from us?
Well, tired as it is, the first thing you can do is take a deep breath. And another. Besides the fact that if you survive from one breath to the next cumulatively you are "making it," breathing is mostly associated with the lungs. The lungs are associated with the metal element, which is associated with the autumn. The metal element is also associated with grief, which doesn't sound so great, but wait a minute. The season before autumn is late summer, which we are currently struggling to escape. Late summer is associated with the earth element, which is associated with thought, or pathologically speaking, obsession. Many of us in modern western society, me at the top of the list, tend to over-think things, and to agonize about things over which we have no control. This is not to say that you should just don't worry, be happy, but it is definitely possible to over-think, and indeed, the Chinese made this one of the 5 possible emotional pathogens. So taking a deep breath (or 50) helps to put your mind back in your body, and not let it rattle around alone, isolated and scared inside your head. If you can move around a little, that should help, too. Next, look around and see what is right there in your immediate sphere of influence that you might be able to impact. This can run the gamut from seeking out coupons and sales, to getting a new job, to volunteering or running for office. Finally, acknowledge when your worst fears don't come true. Somehow we have to keep putting one foot in front of the other for 70, 80 or 90 years, and although at times it can seem like there is only quicksand ahead and fire all around, in fact we mostly make it through an entire life. It may not be the life we dreamed of or hoped for, it may not be a life we would recommend to someone else, and it may seem surprising that we were able, at the end, to have survived it all. Yet we do.
In the west we are strivers. That's cool -- I'm a striver, too. But sometimes our efforts to make things better in ourselves, for our families or in the world around us can go over the edge into a frustrated fantasy. Sometimes we don't measure up to the vision we have for ourselves, and sometimes our families and the world around us don't measure up either. This doesn't take away from the miracle of one breath following another, and one foot following another, and one generation following another. Certainly life is sad, terrifying, frustrating, and anxiety-provoking, and certainly it can cause a lot of sleepless nights and worry over what is to come next. But it's still a miracle. And somehow the ancient Chinese figured out that, at this time of year, we are especially likely to obsess about things we can't control.
Me, I've been writing a lot. Emails, blog posts, essays and two novels I'm working on. I don't know if anything will come of it, but it gives me something to do with my mind instead of waiting and worrying for the phone to ring, either with a paying patient or one of my creditors. If any of you have any writing jobs for me to do, I'm open for business. I'll be the guy at this keyboard working on my skills and taking deep breaths. In 2, 3 --- out 6, 7, 8...
There was a horrifying sequence of items on the radio this morning. The first dealt with the rise in the incidence of people's wages being garnished and bank accounts being cleaned out by debt collectors, many times due to medical debt. The next story dealt with 2500 authors who have contracts with Hachette Book Group -- Hachette and Amazon are in some sort of corporate feud, so Amazon is making it hard for people to buy these authors' books. Because sales have dropped for some of these writers by 90%, they have gone to Amazon's Board of Directors to try to get some relief, but the response so far has been to say that the authors are "naive." The final story addressed the horrible and sad killing of John Crawford, a young African-American man who was recently shot and killed by two policemen in a Walmart because he was carrying a BB gun... which he had taken off the shelf at the Walmart in order to buy it. I guess I'm naive, too. All of these things seem so completely unfair, but not only that, they seem to be actively anti-life -- like social Ebola. The debt collectors get their vig, Amazon makes a few more percentage points of profit, and the terrified beneficiaries of slavery get to neutralize another dangerous black man. But when no one has any money left, when no authors will bother writing books, and when the African-American community realizes that non-violent civil disobedience isn't working in the 21st century, where will we be then? The current state of haves and have-nots will seem like a golden age compared to the walled compounds that the haves will need and the criminal societies that the have-nots will create if things keep moving in their current direction.
Since this is a blog about acupuncture and I try to stick to that subject, this period reminds me a bit of the Warring States period in Chinese history. For about 250 years, beginning around 475 B.C., there was almost constant war between the different regions and clans of China. In the end, the strongest clan started the modern era of dynasties, but it was as much a result of the exhaustion of all the other states as it was the superiority of this one group that led, finally, to this extended period of "peace." The main accomplishment of all this fighting was the consolidation of centralized political power, but that centralized power belonged to whoever could seize it. So in a way the wars were just more formalized and ritualized -- less peasant blood was spilled on the battlefield, perhaps, but the same few rich and powerful families continued to scheme over who was going to run China. This is where, hopefully, China's story and America's would diverge. We are a democratic republic, not an aristocratic empire, so feuding between the states followed by scheming for control between a few rich and powerful families shouldn't be how our story plays out... should it? I have to say, I don't know. We all know the names of the families, first in the Gilded Age (Rockefeller, Carnegie, Mellon, Astor, Morgan, Roosevelt), then through the mid-century (Koch, Kennedy, Schwab, Hilton, Vanderbilt) and into the modern day (Gates, Trump, Buffett, Harriman, Duke). Maybe it is a natural law that the wealthy and powerful will rise to a more and more dominant position in any society -- I just don't know. But perhaps this is more heart-breaking in a society that is rooted in idealistic and egalitarian concepts such as liberty, justice and the pursuit of happiness.
In any event, back to the question: What's an American acupuncturist to do? I have been as panicked as anyone, and I don't usually panic. But a combination of stresses reduced me to tearful feelings of despondency and worthlessness last weekend. Where's the money going to come from for my family to survive, never mind thrive? What will become of my children? Will my wife and I ever again get to travel, see or make art or otherwise enjoy ourselves? How will we survive old age if I become unable to work before I quickly, conveniently and painlessly die? And if I, a well-educated son of middle class white American privilege am having it this tough, what about all the people in the country and in the world who don't have my advantages? How can I or anyone else expect the less fortunate to simply lie down and accept their lack of a future and the total lack of any hope for their advancement? Why wouldn't my unhappy neighbors on welfare (or a bunch of destitute refugees from [name your country]) decide to get some weapons and come try to take our homes and belongings from us?
Well, tired as it is, the first thing you can do is take a deep breath. And another. Besides the fact that if you survive from one breath to the next cumulatively you are "making it," breathing is mostly associated with the lungs. The lungs are associated with the metal element, which is associated with the autumn. The metal element is also associated with grief, which doesn't sound so great, but wait a minute. The season before autumn is late summer, which we are currently struggling to escape. Late summer is associated with the earth element, which is associated with thought, or pathologically speaking, obsession. Many of us in modern western society, me at the top of the list, tend to over-think things, and to agonize about things over which we have no control. This is not to say that you should just don't worry, be happy, but it is definitely possible to over-think, and indeed, the Chinese made this one of the 5 possible emotional pathogens. So taking a deep breath (or 50) helps to put your mind back in your body, and not let it rattle around alone, isolated and scared inside your head. If you can move around a little, that should help, too. Next, look around and see what is right there in your immediate sphere of influence that you might be able to impact. This can run the gamut from seeking out coupons and sales, to getting a new job, to volunteering or running for office. Finally, acknowledge when your worst fears don't come true. Somehow we have to keep putting one foot in front of the other for 70, 80 or 90 years, and although at times it can seem like there is only quicksand ahead and fire all around, in fact we mostly make it through an entire life. It may not be the life we dreamed of or hoped for, it may not be a life we would recommend to someone else, and it may seem surprising that we were able, at the end, to have survived it all. Yet we do.
In the west we are strivers. That's cool -- I'm a striver, too. But sometimes our efforts to make things better in ourselves, for our families or in the world around us can go over the edge into a frustrated fantasy. Sometimes we don't measure up to the vision we have for ourselves, and sometimes our families and the world around us don't measure up either. This doesn't take away from the miracle of one breath following another, and one foot following another, and one generation following another. Certainly life is sad, terrifying, frustrating, and anxiety-provoking, and certainly it can cause a lot of sleepless nights and worry over what is to come next. But it's still a miracle. And somehow the ancient Chinese figured out that, at this time of year, we are especially likely to obsess about things we can't control.
Me, I've been writing a lot. Emails, blog posts, essays and two novels I'm working on. I don't know if anything will come of it, but it gives me something to do with my mind instead of waiting and worrying for the phone to ring, either with a paying patient or one of my creditors. If any of you have any writing jobs for me to do, I'm open for business. I'll be the guy at this keyboard working on my skills and taking deep breaths. In 2, 3 --- out 6, 7, 8...
Thursday, September 5, 2013
The Gout, part 2
Updates (and reflections) on suggestions specific to The Gout: be aware of your triggers and try to calm your trigger finger (by drinking lots of fluids-not-alcohol-coffee-or-tea, altering your diet, using cherry juice and using some kind of diuretic, like celery seed or stinging nettle, as necessary).
If your trigger gets fired, do (painful!) direct bleeding (lancet or thick gauge acupuncture needle) technique at the site of the gout pain, and/or along the spleen and liver meridians (especially at fire/spring points, luo points and xi-cleft points). Also guzzle cherry juice, looking for a bowel movement that will herald the breaking of the "fever" that accompanies attacks of The Gout. When I am having a gout flare, I quit drinking my typical black tea and instead drink cherry juice in hot water – I pretty much only drink water or cherry juice during a flare. I haven't tried turmeric yet, as was suggested above, but I will the next time I have an attack and will report back – turmeric moves blood, so is perfectly consistent with the stagnant blood pain that accompanies The Gout. Other than turmeric, I've personally tried and survived every suggestion published on this blog, but the only ones I continue to use are: bleeding; cherry juice; green and/or stinging nettle tea; and occasionally baking soda in water. Plus I’ve stopped drinking alcohol and coffee and am much more cautious about eating foods with very concentrated flavors, like beans, smoked or organ meat, gravies and chocolate.
Also try to identify the source – in my case, familial, so associated with my kidney qi, but also lifestyle, so associated with spleen qi. The Gout seems to run in families, but if you have a certain kind of really bad family luck, you end up with a rare kidney disease (like in the recently attached nih.gov article) which causes decline of the kidneys accompanied by gout. With this bad luck, you end up with gout that, in Chinese terms, is completely caused by the kidneys themselves. This may seem obvious to a westerner: "Yeah, uric acid, urine, the kidneys, duh?!" But Chinese medicine sometimes sees things in a less straightforward way, which nevertheless sometimes explains and successfully treats conditions that otherwise frustrate us. For instance, although western ideas of kidney and bladder function and uric acid make sense, treating the kidneys and bladder doesn’t usually do anything to help with The Gout. The Chinese kidney meridian starts in the sole of the foot, and circles around behind the inner ankle bone and up the inner leg, and the bladder meridian runs down the center of the back of the leg, into the lateral ankle and foot, and ends on the lateral side of the little toe nail. Although The Gout can ultimately affect any or all joints, it is not particularly associated with the sole of the foot or the inner ankle, nor is it commonly associated with the little toe. It is, instead, very much associated with the big toe, especially the inside of the big toe, where the spleen meridian is located.
Along with its partner, the stomach, the spleen is the primary organ of digestion (most westerners assume that the Chinese are actually referring to the pancreas when they talk about the spleen). Its meridian starts near the medial proximal corner of the big toe nail, then continues over the bunion, along the inside of the arch of the foot, above the inner ankle bone and up the inner leg, knee and thigh. It continues up the torso to the lateral chest, then drops into the center of the ribcage (under your bra strap, more or less) on the side of the body. The spleen is associated with making energy and blood out of food, it likes things that taste good, including sweets, and it is associated with thought, or concentration. Boundaries are particularly important for the spleen, from "How many girlfriends should I have?" to "How much of this delightful beer should I drink?" to "How much of this random blogger's advice should I take?" Reaching your boundaries but not overflowing them is a big spleen concept. However, typically in Chinese medicine the tendency to "overflow" would be associated with the spleen's partner, the stomach. The spleen is thought to be essentially incapable of excess – it would typically only be deficient, because of its constant output of energy in the areas of ingestion, digestion and elimination of both food and ideas. Conceptually, anything can be excessive or deficient, but in practice, the organs have overwhelming tendencies toward one or the other. And the spleen is almost always deficient. But in the case of The Gout, the pounding, fixed pain tells us that it's blood stagnation, which is an excess condition. The spleen is associated with the formation of blood, and if the body is doing something funky in how it makes blood (what science describes as the build-up of uric acid in the blood, with concentrated uric acid precipitating in the affected joint space), then sense could be made of this blood-making digestive organ-related blood stagnation backing up into the meridian, especially if certain foods seem to act as triggers.
What might make the spleen develop such an unusual and intense blood stagnation? Long known as "the rich man's disease," gout has become much more democratic in recent generations. Among other things, a diet that has historically been considered to be "rich" (with plenty of meat, alcohol, seafood, strongly flavored gravies, chocolate and coffee) has become pretty easy to attain for lots of people – and all of these foods are known to trigger attacks of The Gout. My feeling as a periodic sufferer of The Gout is not that I am too rich, but that problems arise when all my wealth becomes concentrated in just 1% of my body. Given that the foods that trigger The Gout all tend to have very concentrated flavors, and given that the spleen is responsible for “concentration” in a mental sense, this seems to be the direction of the unusual excess spleen pattern. In traditional Chinese culture, very few people would have had the luxury of either eating all those rich foods or indulging in lots of mental activity – most people would be busy planting crops and eating the fruits of those labors. In modern America, though, very few of us are planting crops and eating them – most of us are using computers, writing blogs, or otherwise trying to make our living with very concentrated mental activity. And while we’re engaged in all this intense mental activity, we’re eating lots of yummy, concentrated flavor foods… even if we’re not getting fat, we may be eating lots of stuff that is just too rich for our spleens to handle day after day, year after year. Like most accumulations in Chinese medicine, The Gout is part of the curse of middle age – things you could get away with when you were younger you no longer can. Furthermore, during middle age is when you are laying the groundwork for your old age – reining your excesses in, but hopefully leaving yourself some room to enjoy life in healthy and sustainable ways. Try to accept the limitations of the physical and learn from them, not just rail against them. Life is perfect just as it is – it is up to us, as living, thinking creatures, to understand and work with it, not to constantly, willfully try to bend life to our desires.
Which brings us back to the kidneys, which the Chinese associate with the will. Like the spleen, the kidneys are almost never considered to be in excess, and it would be hard to imagine how someone could have too much will to survive… until you think of “willfulness,” and “willful destruction of property,” and “willful ignorance.” Many people who suffer from The Gout have plenty of will, but sometimes it’s misdirected – that is, instead of having a healthy will to survive, and so cutting out some of the foods that contribute to a painful condition, the will is instead directed to “Drink my beer like I always did, dammit, no matter what anyone says!” One might applaud such a spirit, and I do, right up to the point where it becomes self-defeating and counter-productive. My current hypothesis is that The Gout is on the continuum that ends up at pancreatic cancer (spleen luo blood stagnation), so it is not merely pain that is being risked by such a strong display of willfulness, but possibly, ultimately, The Gout sufferer’s life.
Our bodies know things our minds don't, until the mind experiences something like The Gout and has an opportunity to learn. It is seductive to cling to the thing that “makes sense” to our mind, and most western training and thinking is strongly biased toward the mind. In addition, understanding the body’s messages can be difficult, especially because in some cases its message is pretty unflattering. But we don’t know as much as we think we do, and sometimes it is necessary to release what we think we know in order to learn something new. The body is expert in this painful, bubble-bursting style of education.
If your trigger gets fired, do (painful!) direct bleeding (lancet or thick gauge acupuncture needle) technique at the site of the gout pain, and/or along the spleen and liver meridians (especially at fire/spring points, luo points and xi-cleft points). Also guzzle cherry juice, looking for a bowel movement that will herald the breaking of the "fever" that accompanies attacks of The Gout. When I am having a gout flare, I quit drinking my typical black tea and instead drink cherry juice in hot water – I pretty much only drink water or cherry juice during a flare. I haven't tried turmeric yet, as was suggested above, but I will the next time I have an attack and will report back – turmeric moves blood, so is perfectly consistent with the stagnant blood pain that accompanies The Gout. Other than turmeric, I've personally tried and survived every suggestion published on this blog, but the only ones I continue to use are: bleeding; cherry juice; green and/or stinging nettle tea; and occasionally baking soda in water. Plus I’ve stopped drinking alcohol and coffee and am much more cautious about eating foods with very concentrated flavors, like beans, smoked or organ meat, gravies and chocolate.
Also try to identify the source – in my case, familial, so associated with my kidney qi, but also lifestyle, so associated with spleen qi. The Gout seems to run in families, but if you have a certain kind of really bad family luck, you end up with a rare kidney disease (like in the recently attached nih.gov article) which causes decline of the kidneys accompanied by gout. With this bad luck, you end up with gout that, in Chinese terms, is completely caused by the kidneys themselves. This may seem obvious to a westerner: "Yeah, uric acid, urine, the kidneys, duh?!" But Chinese medicine sometimes sees things in a less straightforward way, which nevertheless sometimes explains and successfully treats conditions that otherwise frustrate us. For instance, although western ideas of kidney and bladder function and uric acid make sense, treating the kidneys and bladder doesn’t usually do anything to help with The Gout. The Chinese kidney meridian starts in the sole of the foot, and circles around behind the inner ankle bone and up the inner leg, and the bladder meridian runs down the center of the back of the leg, into the lateral ankle and foot, and ends on the lateral side of the little toe nail. Although The Gout can ultimately affect any or all joints, it is not particularly associated with the sole of the foot or the inner ankle, nor is it commonly associated with the little toe. It is, instead, very much associated with the big toe, especially the inside of the big toe, where the spleen meridian is located.
Along with its partner, the stomach, the spleen is the primary organ of digestion (most westerners assume that the Chinese are actually referring to the pancreas when they talk about the spleen). Its meridian starts near the medial proximal corner of the big toe nail, then continues over the bunion, along the inside of the arch of the foot, above the inner ankle bone and up the inner leg, knee and thigh. It continues up the torso to the lateral chest, then drops into the center of the ribcage (under your bra strap, more or less) on the side of the body. The spleen is associated with making energy and blood out of food, it likes things that taste good, including sweets, and it is associated with thought, or concentration. Boundaries are particularly important for the spleen, from "How many girlfriends should I have?" to "How much of this delightful beer should I drink?" to "How much of this random blogger's advice should I take?" Reaching your boundaries but not overflowing them is a big spleen concept. However, typically in Chinese medicine the tendency to "overflow" would be associated with the spleen's partner, the stomach. The spleen is thought to be essentially incapable of excess – it would typically only be deficient, because of its constant output of energy in the areas of ingestion, digestion and elimination of both food and ideas. Conceptually, anything can be excessive or deficient, but in practice, the organs have overwhelming tendencies toward one or the other. And the spleen is almost always deficient. But in the case of The Gout, the pounding, fixed pain tells us that it's blood stagnation, which is an excess condition. The spleen is associated with the formation of blood, and if the body is doing something funky in how it makes blood (what science describes as the build-up of uric acid in the blood, with concentrated uric acid precipitating in the affected joint space), then sense could be made of this blood-making digestive organ-related blood stagnation backing up into the meridian, especially if certain foods seem to act as triggers.
What might make the spleen develop such an unusual and intense blood stagnation? Long known as "the rich man's disease," gout has become much more democratic in recent generations. Among other things, a diet that has historically been considered to be "rich" (with plenty of meat, alcohol, seafood, strongly flavored gravies, chocolate and coffee) has become pretty easy to attain for lots of people – and all of these foods are known to trigger attacks of The Gout. My feeling as a periodic sufferer of The Gout is not that I am too rich, but that problems arise when all my wealth becomes concentrated in just 1% of my body. Given that the foods that trigger The Gout all tend to have very concentrated flavors, and given that the spleen is responsible for “concentration” in a mental sense, this seems to be the direction of the unusual excess spleen pattern. In traditional Chinese culture, very few people would have had the luxury of either eating all those rich foods or indulging in lots of mental activity – most people would be busy planting crops and eating the fruits of those labors. In modern America, though, very few of us are planting crops and eating them – most of us are using computers, writing blogs, or otherwise trying to make our living with very concentrated mental activity. And while we’re engaged in all this intense mental activity, we’re eating lots of yummy, concentrated flavor foods… even if we’re not getting fat, we may be eating lots of stuff that is just too rich for our spleens to handle day after day, year after year. Like most accumulations in Chinese medicine, The Gout is part of the curse of middle age – things you could get away with when you were younger you no longer can. Furthermore, during middle age is when you are laying the groundwork for your old age – reining your excesses in, but hopefully leaving yourself some room to enjoy life in healthy and sustainable ways. Try to accept the limitations of the physical and learn from them, not just rail against them. Life is perfect just as it is – it is up to us, as living, thinking creatures, to understand and work with it, not to constantly, willfully try to bend life to our desires.
Which brings us back to the kidneys, which the Chinese associate with the will. Like the spleen, the kidneys are almost never considered to be in excess, and it would be hard to imagine how someone could have too much will to survive… until you think of “willfulness,” and “willful destruction of property,” and “willful ignorance.” Many people who suffer from The Gout have plenty of will, but sometimes it’s misdirected – that is, instead of having a healthy will to survive, and so cutting out some of the foods that contribute to a painful condition, the will is instead directed to “Drink my beer like I always did, dammit, no matter what anyone says!” One might applaud such a spirit, and I do, right up to the point where it becomes self-defeating and counter-productive. My current hypothesis is that The Gout is on the continuum that ends up at pancreatic cancer (spleen luo blood stagnation), so it is not merely pain that is being risked by such a strong display of willfulness, but possibly, ultimately, The Gout sufferer’s life.
Our bodies know things our minds don't, until the mind experiences something like The Gout and has an opportunity to learn. It is seductive to cling to the thing that “makes sense” to our mind, and most western training and thinking is strongly biased toward the mind. In addition, understanding the body’s messages can be difficult, especially because in some cases its message is pretty unflattering. But we don’t know as much as we think we do, and sometimes it is necessary to release what we think we know in order to learn something new. The body is expert in this painful, bubble-bursting style of education.
Tuesday, December 4, 2012
Winter 2012 update
Dang! A cowboy's work is never done!
A lot has happened since I last wrote a post, and although it hasn't all been pretty, I've learned a lot and think I'll be able to serve my patients that much better going forward.
First and foremost, my appendix ruptured July 14th. Ten days later* I submitted to my patient wife's gentle suggestions and went to see my physician, who rapidly diagnosed my condition and sent me to the emergency room. A few hours later I was the proud owner of a gigantic vertical scar on the midline of my belly, and I have now made an almost complete recovery -- in fact, I am as insufferable as I have been in years. I would like to thank my excellent doctor, Larry Ginsburg, of Lewisburg, PA; my skillful surgeon, Gary Ayers, also of Lewisburg; and the friendly, efficient and no-nonsense staff at Evangelical Community Hospital in Lewisburg. We are very fortunate to have such a fine facility in our little town, and I am very lucky to have such wonderful doctors looking out for me.
I hope you understand that I intend to use this adventure as my excuse for being offline for so long.
But never mind my sloth, here's some of what I learned and would like to share with you. First of all, I don't know whether to be proud of being so tough (see: cowboy reference above and Aggie reference below) or ashamed of being so out of touch with my own body (see: title of blog, with attendant reasonable expectation of some level of self-awareness, healthy habits and sensitivity to self and others). Maybe I have experienced more intense pain than I care to recall and so have become inured to it (Blessed is humanity's poor memory for pain! Thank you, Mama, for continuing on after my older brother was born!!), but the pain I experienced with my acute appendicitis wasn't anything so special. I mean, my stomach hurt and I didn't feel like going to the amusement park, but I frequently don't feel like going to the amusement park. So the first thing I learned is that appendicitis doesn't necessarily cripple you with pain.
If not for the persistent fever over the next ten days, I might've thought the malaise and discomfort were just a lingering hangover (although I hadn't had a drink in 4 months), or possibly the effects of a bad conscience. As it was, I initially thought I was just constipated, and when I continued to feel poorly after moving my bowels, assumed I was dying of pancreatic cancer, like my late brother. Honestly, it was the combination of my wife's pleas with the tearful awake-all-night planning of what I would say to my three young sons that got me to the doctor. Thank God and Goddess that my melodramatic, paranoid and guilty assumption was wrong. I would describe this as the second thing that I learned, but based on a lifetime of evidence, "Get some help, dummy!" is something that I haven't yet gotten a handle on.
Finally, perhaps the most important thing I learned is based on the aftermath of the surgery. After I was all healed up and had gotten my legs back underneath me, I experienced something very unusual for me. Although it reflects very poorly on my vain and superficial character, for the first time that I can remember, after my surgery I didn't feel sexy and attractive. I didn't particularly think of my belly as an erogenous zone or a particularly attractive part of my body, but once it had a long, dark red, zig-zagging seam up its middle, I didn't much feel like taking my shirt off. I certainly am not feeling like I want to proposition anyone or strut my stuff anywhere. Fortunately my wife still finds me attractive (and I have always felt like I am getting away with something, being allowed to be intimate with such a beautiful, vivacious and talented woman), but it has been a shock, how much this healing experience has left me feeling maimed and undesirable.
Besides saving my life, this realization has been the most valuable part of the experience for me. Many of my patients have had hysterectomies, C-sections and other abdominal surgeries, and many of them have reported feeling undesirable and emotionally disconnected from their sexuality after such surgeries. I only understood it in the abstract before, but now I understand in a much more personal way. It doesn't matter if the car works -- on some true level, if it doesn't LOOK good, it's not much fun to drive. Oh, it will get you to the grocery store and back, but you don't feel much like cruising the Strip or dragging a stranger at a stop light.
I'm sure I'll learn something else after some time has gone by and I've gotten used to my scar -- probably something about thankfulness and letting go (or maybe something about the pleasures of winning races in a beat up Buick with a tank of nitrous under the hood). But for now I am feeling for everyone who has gotten to middle age and then something happened on the outside -- Pffft! -- and everything changed on the inside. It's kind of the opposite of a mid-life crisis, or maybe it's my first experience with an end of life experience(!). Things feel hopelessly, inexorably sober. Responsibility is no longer an option, but the norm. I am fully a father and an adult. I'm not depressed (I know -- I've been depressed), but gravity definitely has a stronger hold on me.
It sucks, but there are worse things.
And soon it will be spring!
February 10**, 2013 on the Chinese calendar. I'll write again then.
*This reminds me of an Aggie joke, and as the child of an Aggie I feel comfortable telling it: A minute before half-time of the annual Texas A&M and University of Texas football game, someone in the crowd threw a firecracker. The Longhorns, thinking it was the gun announcing halftime, filed off the field and into the locker room. Three plays later, the Aggies scored.
** If you read this before today (12/18/12), I had the wrong date... oops, sorry!
A lot has happened since I last wrote a post, and although it hasn't all been pretty, I've learned a lot and think I'll be able to serve my patients that much better going forward.
First and foremost, my appendix ruptured July 14th. Ten days later* I submitted to my patient wife's gentle suggestions and went to see my physician, who rapidly diagnosed my condition and sent me to the emergency room. A few hours later I was the proud owner of a gigantic vertical scar on the midline of my belly, and I have now made an almost complete recovery -- in fact, I am as insufferable as I have been in years. I would like to thank my excellent doctor, Larry Ginsburg, of Lewisburg, PA; my skillful surgeon, Gary Ayers, also of Lewisburg; and the friendly, efficient and no-nonsense staff at Evangelical Community Hospital in Lewisburg. We are very fortunate to have such a fine facility in our little town, and I am very lucky to have such wonderful doctors looking out for me.
I hope you understand that I intend to use this adventure as my excuse for being offline for so long.
But never mind my sloth, here's some of what I learned and would like to share with you. First of all, I don't know whether to be proud of being so tough (see: cowboy reference above and Aggie reference below) or ashamed of being so out of touch with my own body (see: title of blog, with attendant reasonable expectation of some level of self-awareness, healthy habits and sensitivity to self and others). Maybe I have experienced more intense pain than I care to recall and so have become inured to it (Blessed is humanity's poor memory for pain! Thank you, Mama, for continuing on after my older brother was born!!), but the pain I experienced with my acute appendicitis wasn't anything so special. I mean, my stomach hurt and I didn't feel like going to the amusement park, but I frequently don't feel like going to the amusement park. So the first thing I learned is that appendicitis doesn't necessarily cripple you with pain.
If not for the persistent fever over the next ten days, I might've thought the malaise and discomfort were just a lingering hangover (although I hadn't had a drink in 4 months), or possibly the effects of a bad conscience. As it was, I initially thought I was just constipated, and when I continued to feel poorly after moving my bowels, assumed I was dying of pancreatic cancer, like my late brother. Honestly, it was the combination of my wife's pleas with the tearful awake-all-night planning of what I would say to my three young sons that got me to the doctor. Thank God and Goddess that my melodramatic, paranoid and guilty assumption was wrong. I would describe this as the second thing that I learned, but based on a lifetime of evidence, "Get some help, dummy!" is something that I haven't yet gotten a handle on.
Finally, perhaps the most important thing I learned is based on the aftermath of the surgery. After I was all healed up and had gotten my legs back underneath me, I experienced something very unusual for me. Although it reflects very poorly on my vain and superficial character, for the first time that I can remember, after my surgery I didn't feel sexy and attractive. I didn't particularly think of my belly as an erogenous zone or a particularly attractive part of my body, but once it had a long, dark red, zig-zagging seam up its middle, I didn't much feel like taking my shirt off. I certainly am not feeling like I want to proposition anyone or strut my stuff anywhere. Fortunately my wife still finds me attractive (and I have always felt like I am getting away with something, being allowed to be intimate with such a beautiful, vivacious and talented woman), but it has been a shock, how much this healing experience has left me feeling maimed and undesirable.
Besides saving my life, this realization has been the most valuable part of the experience for me. Many of my patients have had hysterectomies, C-sections and other abdominal surgeries, and many of them have reported feeling undesirable and emotionally disconnected from their sexuality after such surgeries. I only understood it in the abstract before, but now I understand in a much more personal way. It doesn't matter if the car works -- on some true level, if it doesn't LOOK good, it's not much fun to drive. Oh, it will get you to the grocery store and back, but you don't feel much like cruising the Strip or dragging a stranger at a stop light.
I'm sure I'll learn something else after some time has gone by and I've gotten used to my scar -- probably something about thankfulness and letting go (or maybe something about the pleasures of winning races in a beat up Buick with a tank of nitrous under the hood). But for now I am feeling for everyone who has gotten to middle age and then something happened on the outside -- Pffft! -- and everything changed on the inside. It's kind of the opposite of a mid-life crisis, or maybe it's my first experience with an end of life experience(!). Things feel hopelessly, inexorably sober. Responsibility is no longer an option, but the norm. I am fully a father and an adult. I'm not depressed (I know -- I've been depressed), but gravity definitely has a stronger hold on me.
It sucks, but there are worse things.
And soon it will be spring!
February 10**, 2013 on the Chinese calendar. I'll write again then.
*This reminds me of an Aggie joke, and as the child of an Aggie I feel comfortable telling it: A minute before half-time of the annual Texas A&M and University of Texas football game, someone in the crowd threw a firecracker. The Longhorns, thinking it was the gun announcing halftime, filed off the field and into the locker room. Three plays later, the Aggies scored.
** If you read this before today (12/18/12), I had the wrong date... oops, sorry!
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