The Conundrum of Pain…and Suffering: Part 1.

I’ve been thinking about writing this piece for a long time. It’s only now that I figured out how I wanted to organize my narrative. It’s complicated because there are so many aspects and approaches to both pain and suffering. The medical profession (and the medical ‘industry’) has its clear claim on the alleviation of pain and suffering. Philosophers and psychologists have also long been interested in the topic. Sociologists too. I won’t be quoting any sources this time. I will leave that for subsequent posts where I deal with specific scholarly and popular approaches to pain and suffering. To start, I want to suggest why I find pain and suffering of interesting.

Pain is not something that can be empirically determined. It cannot be objectively measured as far as I know. If you know otherwise, please let me know. That’s why doctors (MDs, that is) sometimes ask you: “On a scale of 1 to 10, how bad is your pain right now?” You answer: “Gee, I don’t know.” And you just throw out a number because it’s such a hard question to answer. You don’t want to say 2 because then what the hell are they doing in their office? You don’t want to say 10 unless you’re writhing in pain on the floor by the examination table. A 7 is usually good for attracting attention without getting ‘the look’. Still, your doctor may be wary.

You can look at anyone, I don’t care whether they have just been badly damaged in a car crash, they have arthritis, psoriasis, lumbago (don’t you just love that word?), and/or gout. You can impute that they’re in pain, but it’s not visible. Pain is not visible. You cannot see pain. It hides in the crevices, nooks and crannies of your body but nobody can see it so how do we know it’s really there? We may see a person with a massive slashing knife wound to the chest and we assume that person is in pain, but we never see the pain so we don’t have any way of determining its intensity or how much shock or other factors have mitigated or attenuated it.

Recently we (Carolyn and I) spent some time in a hospital emergency department because Carolyn needed an emergency appendectomy. All is much better now, but it was obvious that the medical staff were at a loss the first time we went to emerg (that’s what they call it, you know) to figure out what the cause of Carolyn’s pain might be. They may have even wondered whether or not her pain was psychosomatic. They poked and prodded her, took blood and did a CT scan. Nothing of significance was found. I don’t know what the staff thought at the time. They told her she was a conundrum and looked great on paper. In any case, we were sent home with instructions to take antibiotics, pain killers, etc. When over the next few days the pain got worse for Carolyn we went back to emerg after Carolyn was told by her family doctor that she had a classic case of appendicitis. After a few more hours sitting in waiting rooms and getting more tests including a second CT scan, it was determined that indeed, Carolyn had acute appendicitis (which we subsequently found out was evident on the first CT scan). Time for surgery for a ruptured appendix. This entire scenario was upsetting and did not need to happen. Surgery after our first visit would have been routine and we probably would have come home the same night. As it stood, Carolyn spent two days in the hospital recovering. Now, this was all nasty and everything, but I have questions about the presence of pain as Carolyn described it and the CT scan that showed an inflamed appendix. Did they operate because of the pain or because of the CT scan? The CT scan confirmed that there was an organic problem and the assumption that Carolyn was in pain may or may not have factored into the decision to operate. I’m not sure how that works.

Pain is not something that is determined objectively so how are medical personnel to know whether a person is in pain or is faking it? There are people out there who crave attention and will fake medical symptoms to get it. There are people who have what’s called indeterminate illnesses or diseases of indeterminate etiology like fibromyalgia. Some medical doctors and others associated with medicine still don’t believe that fibromyalgia is a thing. They argue that if only you’d relax, your pain would go away…that’s if you ever really had pain…wink, wink, nudge, nudge. It’s a tough call because pain is not visible. People may be grimacing and walking abnormally, and we assume they’re in pain, but we just don’t know for sure. There is probably more attention given to determining the etiology of pain in regular and emergency medicine than anything else. Guesswork has to play a major role along with targeted questioning. “Does it hurt here? No. Here? No. Then what about here? Okay, here then! Well then, we’ll just peel you off the ceiling now and figure out what to do for you. You will definitely need some painkilling meds. Get that IV hooked up. It’s certainly true that pain alone cannot trigger surgery. Just because I tell a doctor I’m in pain, that doesn’t justify her throwing me straight into the operating room. Subjective reports of pain must be supported by evidence of organic abnormality, or is it the other way around?

Killing pain is huge business. We don’t seem to like pain a lot unless we have a personality disorder and we’re masochistic. Big Pharma’s bread and butter is in killing pain. Opioids are huge business. They are used medically to mitigate physical pain symptoms, but they are also used on the street to deal with ‘psychic’ pain. [This is a topic for another blog post.]

Strangely enough, we often put ourselves through a lot of pain and suffering to accomplish a task that we’ve imposed on ourselves like running a marathon. Why run a marathon only to feel intense pain during and afterwards? What drives us to doing this kind of thing? [This is a topic for yet another blog post.]

Then, there are people, a very small minority, who cannot feel physical pain at all. They can put their hand on a hot stove element and not know that they are in trouble until they smell flesh burning. That’s not a scenario that appeals to me at all. In view of this it’s common to consider that pain has benefits in an evolutionary sense. It’s probably a damn good thing that we do feel pain. Too bad our pain is not obvious to others in an objective way. It would make life a lot less painful for a lot of us.

Private Property on Reserves in Canada: 5 myths.

While I’m gestating my next blog post, I thought I’d post this excelled article from the Star in 2012. There is so much misunderstand, prejudice and discrimination even among mostly reasonable people with regards to indigenous and First Nations people in Canada that anything that can be done to dispel myths about them is good by me. This article falls under that category. Click on the link below for the full Star article by CHRISTOPHER ALCANTARA.

https://www.thestar.com/opinion/editorialopinion/2012/08/19/private_property_on_reserves_5_myths.html

 

Some thoughts on comfort and ease.

So, I’ve been reading a lot lately and Carolyn has just been through an emergency appendectomy. Not that the two things are related. I don’t think my reading has brought on Carolyn’s appendix woes, but her woes are real and are making her very uncomfortable and in disEASE.  I often read in bed. I’ll go to bed around 9 in the evening or so and read for a couple of hours, if my brain will let me. I sometimes wake up with my head in my book, drooling. It’s 2 in the morning and my reading light is still on. At that point I make the sensible decision to shut the light, put my book away and snuggle into my blankets with the hope of a good sleep. It doesn’t always end up that way, but sometimes it does.

I like my bed. It’s comfortable. It never disappoints me. It’s a steady friend unless the surgery I had 50 years ago on my lower back decides it’s time to mess with me and I toss and turn just hoping to find a position that will allow me to drift off to sleep. Well, if my back co-operates my wrecked rotator cuffs sometimes take up the challenge of keeping me awake. They’re often quite successful. In fact they’re always successful. My arms and hands go numb, tingle and hurt like hell. Damn. That’s when I give up and take a T3 (that’s Tylenol with codeine). Now, I know that’s a narcotic, but, damn it, at least after I take it I get some sleep. Problem is when I wake up in the morning I have the equivalent of a hangover and it takes a while for my arms to respond reasonably to a little movement without making me nauseous. It’s distinctly unpleasant but a T3 eases my pain, dammit!  I find it hard to admit that a narcotic can give me comfort, but there you have it. It just does. I have a bigger, tougher, narcotic, hydromorphone that I can always use when I get into dire pain straights. That hasn’t happened in a long time and that’s a good thing because I don’t want to feel stoned all the time. I can’t get anything done when I’m ripped and I thrive on getting things done. Still, I know that if I need them, I have the little white pills. It’s a comfort to know that they will be there to ease my pain if I need them. They never fail me.

So, I think that comfort and ease for me reside in the familiar, the predictable, the physically pleasant sensation of benign homeostasis. I like that. Business has long realized that people seem to seek comfort and ease so we are constantly bombarded with ads trying to sell us products that are designed to make us more comfortable or to make life easier for us. The big luxury car with all the automatic gadgets you can conceive of at our fingertips makes life easier, doesn’t it? The automatic dishwasher, the coffee maker, the vacuum cleaner, the tons of shop tools I have, they’re all designed to make life easier for me and thus bring me more comfort.

We love comfort and ease when we travel too. Some people pay a lot of extra money to fly first class. Well, there are the prestige and showoffy aspects to that, but comfort and ease are a huge draw too. Ah, room to stretch out, lots of leg room, complimentary drinks. Sometimes our travel destination is a tropical island. We long to lay on the beach in comfort baking our bodies to a darker shade of white (depending where you are on the spectrum to start with). We love luxury hotels too because they’re so comfortable and people do everything for us.

So, I hope I’ve sort of established that we love comfort and ease in our lives. The problem is, that comfort and ease are certainly not the only goals to which we aspire. In fact, discomfort and pain can just as easily attract us. We are such fickle beings. Take golf for example. I don’t play the game because I don’t want to endanger people’s lives in the vicinity of the golf course. If I hit a ball, I have no idea where it’s going to go. But why bother in the first place? I would play golf if I were allowed to carry the ball around and drop it into the holes as I walk the course. Perfect score every time! Doesn’t that make much more sense? It would be a lot easier. Well, of course, it doesn’t make more sense. No challenge in that! No chance of experiencing the pain of defeat! But no chance either of being a sub-par hero. So, no, we don’t always seek comfort and ease. If we did, we would never climb mountains nor would we compete in any sport or game. As a species we seem to need a good measure of both comfort and discomfort, ease and unease. Marketing firms are masters at finding under what circumstances we seek comfort or discomfort. Sometimes both values are pitched in a single ad.

Now, my point. It seems like a truism to suggest that homeless people are also drug addicts and lazy slugs. I don’t have the statistics in front of me, but just by simple observation it strikes me that most people feel that the poor, but especially the homeless, are hopeless addicts and moral degenerates. I just want to suggest to you that if I were homeless, I would try to find some way to find a reasonable balance between comfort and discomfort, ease and unease. That’s just what we all seem to want. However, because my options as a homeless person would be so limited, the only way I could experience even a few moments of comfort and ease is by getting as stoned as I could. Passing out would be a blessing.

If I were homeless, I’d be wrecked as often and as completely as I could be. Good thing I’m retired with a decent pension. This way I can stay reasonably clear headed although I won’t turn down a good single malt scotch if it’s offered to me. If nothing else it helps with the pain!

Homelessness has deep roots in economic, social and psychological dimensions. However, if we are to do anything about homelessness as some of us are keen to, we have to set up our world to provide people a reasonable shot at achieving a balance between comfort and discomfort without them resorting to consuming excessive amounts of alcohol or drugs to get there. For a homeless person, it’s reasonable and rational to get as drunk or as stoned as possible. It always amazes me that no where near the number of homeless people resort to booze and drugs as some people think. Part of the reason, methinks, is because people create community on the street. There is comfort in community. Community is an antidote to drug and alcohol abuse for the homeless and a piece of the road to balance between comfort and discomfort for the rest of us.

An early 20th Century sociologist made the same argument as I have in this post only using different analogies and a different focus. I’ll write about his work soon in another post.

 

No Post. No Cry.

I’m tired. I’ve done a lot of reading and writing in the first six months of this year and I’ve done some paintings and other kinds of art work for an auction or just because I wanted to. I’ve also spent time with my family and carry on with my volunteer work with various local non-profit societies. So, I haven’t published anything on this blog lately and I’m not apologizing for that. I haven’t been idle but nor have I felt compelled to write more words here, particularly after the blitz of writing on misogyny I carried on in the past few months.

I’ve been reading some work by Jordan Peterson and have written some commentary, but it sits unfinished. My verdict on Peterson is still out. He obviously is a guru to some and an evil misogynist to others. I can’t deny either view of him. I can, however, challenge him on his shallow analysis of people like Karl Marx, his straw man and ad hominem attacks. Peterson seems to know very little about Marx beyond textbook treatment of him yet is quite prepared to be highly critical of the man.

I’m reading a 2016 biography of Karl Marx by Gareth Stedman Jones at the moment. It’s quite good, not without its flaws, of course,  but I won’t comment on it just yet. I’ll save my comments for after my book club has read it. Should be by the end of July, beginning of August. Like all historical figures, Marx was vilified and glorified without much justification in either case. Certainly, Marx was used. More later on that.

I’m feeling myself drawn back to my long standing interest in morality and its roots. After a bit of a break I’ll get back to writing about it again. One thing is certain, I feel very strongly that the way we live determines the way we think, what we think and our general value systems. I don’t mean this in an individualistic, but in a cultural sense. We aren’t generally aware or pay attention to these things any more than fish wonder about the nature of water. Criticism, meaning the practice of dissecting a perspective, an idea, a philosophy, etc., is not something we come by naturally. Criticism and science are kin. They involve the same process. They also are considered a threat to social solidarity for some. A lot of people don’t take kindly to too close a scrutiny of their values and ideas or of their favourite organizations like their country. Sorry, folks, but that’s what I’m all about.

Sleep now.

 

 

From the Times Literary Supplement

https://www.the-tls.co.uk/articles/public/grave-expectations-death/

Until death do us part. This is a great review of a subject most of us dread. The fear of death and dying and the obsessions that fear engenders often keep us from living life to the fullest. Are we programmed to fear death? Is it in our genes? It is a huge part of our culture.  Fully institutionalized death denial permeates deeply into our everyday lives whether we are religiously inclined or not.

Read on.

Mobile Phones for kids: Yes or No?

– with Carolyn Kirk-Albert

…if both parents have a mobile (cel) phone but there is no landline in the house, how are kids supposed to communicate with their friends?

Carolyn and I just happened upon this conversation 3 or 4 days ago. I don’t recall how we got to it, but as we got into it, we thought ‘I need to write about this.’ So, here I am and here we are.

The issue starts with the fact that there are fewer and fewer households in North America with a telephone landline. More and more people are using mobile smart phones as their prime mode of interpersonal communication. Carolyn and I have not had a landline in quite some time. It just seemed redundant to have 3 phones for 2 people. Besides, as this article from The Star (May, 2017) points out, landlines have become spam magnets or a honey trap for telemarketers. Towards the end of the time we had a landline, the only calls we got on it were from telemarketers or spam freaks. Giving up our landline did have consequences for our kids though. When they wanted to phone home, they had to decide which parent they would speak with. They still do. Sometimes they call me, sometimes they call their mom. It depends on the issue.

The situation is that landlines are losing ground to mobile phones as household communications devices. This article from the CRTC makes that argument. The evidence is clear. The article also points out, perhaps counterintuitively, that poorer households are more likely to use mobile phones exclusively. It’s a cost issue for them. For us too.

However, the issues we want to raise here are the consequences for the children in a household without a landline.  How does not having a landline affect their social lives? For us, when we were kids (yes there were phones back then) we could pick up the phone and call our friends. True, our parents might get upset at us for hogging the phone lines, especially in the days when there were still party lines (many households sharing a phone line), but if we were respectful and reasonable, our parents readily allowed up to talk to our friends, set up play dates, etc.

Now, if both parents have a mobile (cel) phone but there is no landline in the house, how are kids supposed to communicate with their friends other than face to face in the school yard? Logically, it can only happen with their parents as intermediaries. So, if little Beth wants to play with little Sammy, Beth’s mom or dad will have to phone Sammy’s parents to set up a play date. The kids may not be able to talk to each other except face to face.

So, when is it okay for kids to get their own mobile phones so that they can communicate with their friends directly? There is a cost involved. That’s a drawback. There’s also the issue of supervision. And, kids can lose their phones. (Adults can too, of course.) Understandably, parents want to know what their kids are up to. Still, the question stands. Aside from the cost and supervisory issues, when does it make sense for kids to get their own phones? The phones can be restricted to local calls only and online times can be monitored.

We don’t know. We’re grandparents. Our grandchildren are getting to that age, however, when they are getting interested in these issues. Maybe kids need to phone their friend’s parents’ mobile phones and ask the parent to pass the phone over. In a sense, that’s what we did as kids. Someone answered the phone and passed it over to whoever the call was for. Is that an issue? Are parents going to be into that: having THEIR phones taken over by their kids. I’m thinking that’s not likely.

I guess Carolyn and I just got to thinking about the social consequences for families of increasing exclusive use of mobile phones. There’s always some fallout, someone that’s left out. Mobile phones are the ideal individual communications device, but they don’t promote sharing or family. It seems to us that they further alienate us from each other and set the stage for our treatment more as individuals then as family members.

Just a thought. Your comments are always welcome whether you have kids or not.

What is a historical fart?

This is too funny. I used to use a book called What Is History by E.H. Carr when I was teaching sociology decades ago. He wrote the book in 1961 or so and I have a paper copy of it somewhere but for convenience, I just opened a pdf copy of it online. Well, in a way that is quite common, the scanner they used to create the pdf wasn’t perfect and it interpreted a few words in a highly questionable manner. The following text appears on pages 12 and 13 of Carr’s book and it speaks for itself:

Let us take a look at the process by which a mere fact about the past is transformed into a fact of history. At Stalybridge Wakes in 1850, a vendor of gingerbread, as the result of some petty dispute, was deliberately kicked to death by an angry mob. Is this a fact of history ? A year ago I should unhesitatingly have said’ no \ It was recorded by an eye-witness in some little- known memoirs2; but I had never seen it judged worthy of mention by any historian. A year ago Dr. Kitson Clark cited it in his Ford lectures in Oxford. Does this make it into a historical fart? Not, I think, yet. Its present status, I suggest, is that it has been proposed for membership of the select club of historical farts. It now awaits a seconder and sponsors. It may be that in the course of the next few years we shall see this fart appearing first in footnotes, then in the text, of articles and books about nineteenth-century England, and that in twenty or thirty years’ time it may be a well-established historical fart. Alternatively, nobody may take it up, in which case it will relapse into the limbo of unhistorical farts about the past from which Dr. Kitson Clark has gallantly attempted to rescue it. What will decide which of these two things will happen? It will depend, I think, on whether the thesis or interpretation in support of which Dr. Kitson Clark cited this incident is accepted by other historians as valid and significant. Its status as a historical fart will turn on a question of interpretation. This element of interpretation enters into every fart of history.