Seizures! What else now?

After at least two consultations with nurses and an oncologist, my GP has decided that I’ve probably had a couple of seizures over the past few months. Great.

Lately, after an internet conversation with one of my blog readers I wrote to them about how fully my life had become medicalized. See if you agree with me: I take a bunch of pills morning and evening to deal with cancer and pain. I go to the hospital twice a month for bloodwork and a two-hour infusion of Daratumumab. Monday we went to Nanaimo so that I could get a corticosteroid (dexamethasone) injected into my seventh cervical vertebrae to deal with the chronic pain in my neck; Tuesday morning I had an appointment with my GP for a prescription renewal, and to discuss a plan to send me to Nanaimo again, this time for an EEG if the CT scan I got Tuesday evening showed nothing. In fact, it did show nothing that could explain the two seizures I’ve had over the past few months, one very recently, so off to Nanaimo I go.

The thing is, if they find an abnormality in my brain using the EEG, they will simply want to put me on another drug, an anti-seizure drug. I’m already pickled in meds so why not another one?

My life seems to be driven by medical issues. I’m not alone in this, of course. Many of us have a close personal involvement with medicine, whether in the form of physicians, specialists, pharmaceuticals, hospitals, and various other medically-related bureaucracies like our Health Authorities in British Columbia, possibly all of the above. They should actually be called Sickness Authorities because that’s what they deal in, sickness. 

The provincial budget allocates billions of dollars for illness related issues. It’s hard to pinpoint exactly how many billions of dollars because they get spread out over several spending categories. For instance, the Ministry of Health is projected to spend approximately $25.5 billion in 2022-23 of an estimated $71 billion in total budgetary expenses. There’s another approximately $8.6 billion for infrastructure related to health. I assume the new Dementia Village in Comox falls under this category. Aging and dementia are health issues, apparently.

So, tons of money is spent every year on health issues. I account for some of that, I certainly do. The Daratumumab I get by infusion every month costs a reputed $10,000 a pop. Now that’s a big investment in my being. I’m not sure it’s justified, but it happens because of an overarching ethic dominated by the fear of death and the perceived sanctity of life. As Ernest Becker points out in Escape From Evil, the twin pillars of evil for us humans are death and disease. We do everything we can to fight them. Obviously we fail completely in dealing with death, and fighting disease is often a losing battle too. So, what are we doing? What’s the point? What if we had no ‘industrial’ medicine? Humans lived on this planet for millions of years without doctors, hospitals, and pharmaceutics? Why do we spend so much on them now? 

I can safely conclude that part of the motivation for spending such inordinate amounts of money on ‘health’ is to keep the workforce working and reliable day after day, week after week, year after year. Industry requires consistent effort from the workforce, especially from those workers with technical or managerial skills. Another motivation is the transfer of power from workers to managers, in the case of health, from us ordinary folk to the specialist professionals, doctors. 

Since the 19th Century and the advent of scientific management, the control of commodity production has fallen on the managerial class. Workers have been stripped of all control over the productive process. In the case of health, doctors are the managers of our health. We negotiate with them to some extent, we even oppose them at times, but by and large they are in control. I must say though, that that situation is changing and your ordinary GP is becoming more and more a worker for a large bureaucratic organization that controls multiple clinics. Some American hospitals, for instance, extend their control over health spending and profits by buying out or establishing clinics where doctors are employees like any other. 

Obviously we live in a capitalist world where possessive individualism rules, where business is allowed to create products and services that may or may not be conducive to healthy bodies and minds. The fast food business is clearly not interested in our health. Money is the name of the game. Any deleterious consequences for our wellbeing caused by eating too much fast food is addressed by public spending on hospitals, doctors, pharmaceuticals, et cetera. Pharmaceutical businesses might initially be organized with an eye to alleviating human suffering and enhancing wellbeing, but it seems that they soon fall in line with all capitalist ventures in the need for profit above all other values. They depend on illness for their profits. I don’t think that’s such a good thing.

Then I got to thinking. I remember when I was a grad student reading a book by Michel Foucault* called The Birth of the Clinic: An Archaeology of Medical Perception. It was written in the early 1970s. The translation into English from the French (Naissance de la Clinique) has a 1973 Copyright date. Foucault was a prominent critic of institutionalized criminal incarceration, the medical clinic, madness, and sexuality, among other topics. He was a very controversial figure in French academia for decades, and a very prolific writer. He’s a ponderous writer to some, but an elegant exegesist to others. I find his critiques compelling in some ways, but belaboured in others. In other words, he’s complicated.** 

In his book on the rise of the medical clinic, his major point is that the medical ‘gaze’, the creation of a specialized, comprehensive, and institutionalized consideration of disease and pathology would become the exclusive domain of the medical clinic. We’ve even been convinced that pregnancy and aging fit nicely under the medical gaze. Other commentators on the power of modern medicine such as Ivan Illich emphasized the class basis of control over human health whereby we become supplicants in our relationships with doctors, whereas Foucault and his followers see the medical/health landscape as a set of power relations that work to “reproduce medical dominance” (Lupton, page 88). 

Because we are so freaked out about death and disease, Foucault would argue, we negotiate our necessarily subordinate relations with our doctors on an ongoing basis. According to Lupton, there is collusion between doctors and their patients to reproduce the system of medical dominance. That’s true in my case, certainly. Without modern medicine, I’d be dead right now.

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*The Passion of Michel Foucault (March 1, 1994), by James Miller is one of the best biographies I’ve ever read. It’s balanced, decisive, and comprehensive. Definitely worth a read. Come to think of it, I need to read it again. 

**See Deborah Lupton, Foucault and the Medicalization Critique, Chapter 5 in Foucault, Health, and Medicine, Edited by Alan Peterson and Robin Bunton, 1997, Routledge: London and New York. 

Our Vagarious Lives

Our Vagarious Lives

Ah, the weather is still out to lunch. We are at least a month behind in the garden. The wisteria is not showing any signs of blooming. Just sticks up there. Last year at this time it was in full bloom with a small complement of leaves coming forth. Some plants, notably some ferns and, thankfully, the garlic seem to be quite happy. 

Garlic Bed

So is the Japanese Butterbur. Within a month it went from three or four buttons at the bottom of the garden to what looks like giant rhubarb. The leaves are so heavy they fall back on themselves.

Spring time has always been considered a time of joy, growth, and possibility. And so it is. Like a baby born with all the potential of a lifetime ahead, the garden is looking to the future of the rest of the spring and the full delight and warmth of summer. Fall and Winter come inevitably. They tease us with beautiful garden colours and the bare branches of winter which then carries on for what some of us think is way too long. Spring does finally come around again and soothes us with hope. We commonly call what I’m talking about here as the cycle of the seasons. Of course, it’s not a cycle. It appears to be, but last spring is not this spring. It might be more accurate to talk about the spiral of seasons.

Like one year in the vast scheme of things, a human life is that time between our birth and our death. It’s finite. This is not a fact we find comfortable because, gee, we live through many springs, summers, falls, and winters. We are not just one-year wonders. That’s true, but the illusion of the cycle of seasons should not fool us into believing that this thing goes on forever.

To carry on with the analogy of the garden and human life, for me, winter is not coming, it’s here, even during the month of May. My leaves are falling, my bark is dry and cracking. There is no moving forward to a new spring for me. If that were to happen, it would defy all evolutionary logic. No, I have to be satisfied with my life as it is, and I am, even if I am in my ‘sunset’ years. I have an intelligent, talented, and beautiful wife and my daughters have taken after their mother. I have a loving family, and I live on a gorgeous garden thanks to Carolyn’s magical touch and hard work.

There’s one thing I agree with Sadhguru* about and that’s the idea that we had better enjoy life while we can, because we’ll be dead for a long time. Of course, many people are unhappy with the coming of winter, period, and they deny it by vacationing in Mexico or somewhere else near the equator or on the other side of the planet where summer coincides with our winter.

For a time as I read Sadhguru I had the sense that he really understood Evolution and Life, Science even. For example, when he argued that we don’t die, I thought maybe he referred to the (scientific) notion that every atom that makes up our body has always existed and always will. In that sense, ‘we’ are immortal. From my perspective, our consciousness is toast, but the little things that together constitute our bodies carry on. There is some disagreement about this, but the cells that make up our bodies get replaced at various rates for a very rough average of every seven years or so in total. Another strange factoid: we very likely breathe the same air molecules that Caesar exhaled during his last breath. Cool. But Sadhguru didn’t go there. He still insists on the survival of consciousness.

So, we exist at many ‘levels’: atomic, molecular, cellular, and organic. All of these together make it possible for us to have consciousness. Once our physical platform is gone our consciousness follows. I’d be glad to change my mind about this given scientific evidence to the contrary, but that is very unlikely.

So, what’s vagarious about our lives? Well, the dictionary defines vagarious as: “erratic and unpredictable in behaviour or direction.” Boy, is it ever. One day I’m able to walk long distances with Carolyn. The next day I can barely walk at all. I would not have predicted that. Cancer and old age gang up on me and don’t back off, ever. That’s life. There’s a slew of things I used to do effortlessly. Now, every once in a while I still think I can do things but after trying for a bit, I realize that I can’t go back in time. The trick for me is accepting my new age-appropriate capabilities. I’m living the life of a seventy-five year old, not a fifty-five year old. I must accept that and not sweat it. I’m getting it. It’s a process. It’s a good thing I have Carolyn and my family to remind me from time to time of my limitations. I need reminding.

I’m quite fond of metaphor and analogy as you are probably aware by now. Well, let’s pull out another one. Cancer is like cats as they play with us mice. There are many flavours of cat, some hunt mice and kill them quickly. Some play with their mice prey for some time before losing interest and finally killing them.

I have multiple myeloma. My cat analogue is one that likes to play with its prey. Little shit. It bats me around and chases me under the dresser where I get a bit of a respite knowing full well, Mr. Cat Myeloma is just out there, waiting for me to lose patience and make a run for it. I have absolutely no chance of escape. So be it. That damn cat will get me, no doubt, but not yet.

I love the garden. Carolyn has done an amazing job cultivating it, encouraging it, and never losing faith in it.

You never know, though. I may get it into my head that I can do things again that I used to do effortlessly. I may try. I can still handle a chainsaw. I got mine started a few days ago. I need to sharpen the blade. I think I can do that. Time to find out, but I do need to be cautious, now don’t I?

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*I wrote about Sadhguru on my May 4th post: https://rogerjgalbert.com/2022/05/04/aw-come-on-lets-talk-about-death-some-more/

Slowly Falling Apart

For this post, I decided to create a collage of quotes and commentaries from books I’ve been reading lately. They range from comments on death and dying to philosophy, culture, and the future. So far in this blog, I’ve refrained from commenting on American Congressional politics, but I just may go there soon. I told my sociology students year after year throughout my college teaching career that the American empire would fall, as all empires fall, not from external conquest but from implosion due to unresolved, long standing conflict. The American empire, specifically, will fall because of commodity production that depends on longer and more complex supply chains and failing profits. America is falling on its own sword of profits. Supply chains and economic processing zones in a plethora of ‘developing’ parts of the world have been an issue for decades while only recently making it onto mainstream media commentary and news. I’ll explain in a future post.

US politics has to wait. It’s a mess down there but it’s a mess everywhere on the planet at the moment. Let’s move on.

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Robert Sapolsky is one of my all-time favourite guys. He has a number of his Stanford University lectures on YouTube. He’s a neuroscientist who specializes in stress. He worked in the field for many years with Olive baboons in Africa. I have a video in which his work with the baboons is featured. On the topic of the human condition he writes:

“we are now living well enough and long enough to slowly fall apart. The diseases that plague us now are ones of slow accumulation of damage—heart disease, cancer, cerebrovascular disorders.” (from “Why Zebras Don’t Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping (Third Edition)” by Robert M. Sapolsky)

Now, ain’t that the truth! If you check out Stats Canada’s vital statistics you’ll find out that cancer is the leading cause of death in Canada. Actually, life is the leading cause of death everywhere, but as far as the observable evidence of bodily decay and death goes, cancer is determined to be the immediate major causes. Writing this makes me want to go back and binge watch Sapolsky on YouTube. Not only does he have a lot to say, but he says it in such an engaging way that binge watching is entirely feasible. I’ll be sharing more from Sapolsky later, but now on to another very different writer.

This is a quote from another book I’m reading that I want to share with you. Talk about falling apart! Robinson is a contemporary novelist writing in the sci-fi genre with dystopian tinges. He writes:

“Say the order of your time feels unjust and unsustainable and yet massively entrenched, but also falling apart before your eyes. The obvious contradictions in this list might yet still describe the feeling of your time quite accurately, if we are not mistaken. Or put it this way; it feels that way to us. But a little contemplation of history will reveal that this feeling too will not last for long. Unless of course the feeling of things falling apart is itself massively entrenched, to the point of being the eternal or eternally recurrent individual human’s reaction to history. Which may just mean the reinscription of the biological onto the historical, for we are all definitely always falling apart, and not massively entrenched in anything at all. 31 India” (from “The Ministry for the Future: A Novel” by Kim Stanley Robinson)

Most of this quote will be difficult for you to fathom because it’s out of context. It’s the last sentence that really matters. To help you out a little with the context of this quote, the ‘order of your time’, in the first sentence means that in the course of your life you feel out of control. You can’t go back, you can’t stay still. You can only go forward towards your death. This applies not only to us as biological entities but also to our cultural and social constructs which also are bound to come and go in a generally disorderly way. We cannot be ‘massively entrenched’ in life because daily existence makes a lie of any attempt to avoid moving toward death.

Now, more from Robinson in another of his sci-fi novels set far from Earth on a ship and a moon.

“Existential nausea comes from feeling trapped. It is an affect state resulting from the feeling that the future has only bad options. Of course every human faces the fact of individual death, and therefore existential nausea must be to a certain extent a universal experience, and something that must be dealt with by one mental strategy or another. Most people appear to learn to ignore it, as if it were some low chronic pain that has to be endured. Here in this meeting, it began to become clear, for many of those present, that extinction lay at the end of all their possible paths. This was not the same as individual death, but was instead something both more abstract and more profound.” (from “Aurora” by Kim Stanley Robinson)

Robinson is not a great writer in terms of composition, but he is a very perceptive commentator on the human condition. His novels are all about the fragility of humanity in the face of evolution and death, both on an individual and social level. Death denial is a consistent theme in human history and as a goal, has engendered a mass of immortality tales with “supernatural” characters as diverse as Zeus, Jesus, Shiva and a mess of lesser gods. These characters are our heroes who will save us from death if only we believe in them. But then we come face to face with evolution and biology which care not a wit whether we believe in them or not, and which just carry on.

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So, what about falling apart?

It’s clear that average death rates have risen consistently over the decades on the planet although in the US they’ve been falling for some demographics. Falling or not, on average we live well into our seventies. In fact, Stats Can tells me that if I live to be seventy-four I can expect to live another fourteen years. These are average life expectancies, of course. Millenia ago, living to thirty-seven years of age was considered average. People died of things then we seldom die of these days (such as appendicitis).

Sapolsky understands that the longer we live the more things can go wrong in our bodies. That’s self-evident the longer we live. If we get injured while young we can expect to heal and then just get on with things. As we (I) get older the healing process slows down.

There are a few very fortunate people, especially in the world’s richest parts, who suffer very little as they get old. I don’t think I know any of those people (well, maybe one or two). That said, there is an inevitable decline in capacity as we age. That doesn’t mean we should stop living and simply prepare for death because we know it’s going to happen. For me, I have much reduced capacity. At seventy-four I have maybe a quarter of the capacity I had at fifty. But a quarter is better than nothing. I still have shit to do! I’m falling apart, yes. In fact, I can’t fall much farther, but that’s fine, I still have a way to go.