Sleepless in Cumberland

Yesterday was my day at the hospital for my monthly infusion of Daratumumab, the monoclonal antibody. It along with other flavours of monoclonal antibodies have changed a lot about how medicine thinks about and treats cancer, arthritis, and other nasty ailments of us fragile mortals. Along with my Dara, I also take some dexamethasone, only 12 mgs for the month, and a few other meds designed to protect me from viral infection. It’s the dex that keeps me awake as I’ve noted many times on this blog. 

So, instead of lying awake, allowing whatever thoughts I had rattle around in my brain causing no end of silly talk, I decided to read instead. Reading is a good way of filling in the night hours in what some people would call a ‘progressive’ way. However, I may need to revise the material that I choose to read at night. I haven’t read a lot of fiction in my life, focussing my reading time on sociology, anthropology, philosophy, and other sundry disciplines. I have read most of Kurt Vonnegut’s work, all of Emily St. John Mandel’s books and I did recently read several books by Kim Stanley Robinson, fictional accounts of the human colonization of Mars, New York under flood, and other similar topics. In his Mars trilogy one interesting commentary was on longevity. If people accepted a certain treatment, they could live hundreds of years instead of the paltry number of years generally allotted to our species. That fact, however, did not seem to mitigate the angst they felt about death and dying. In a book called Aurora, Robinson is at his most pessimistic about human excursions to other planets and their satellites in our solar system. His conclusions about the time it takes to travel from Earth to other planets are telling. Travelling to and back from a satellite of Venus, for example may take a hundred and seventy years or more with the need for cryogenic sleep. So, if you were one of the ‘lucky’ ones who won the lottery for space travel you would return to Earth after several decades of travel at a time when no one would know you, you would have no recognizable family and you would be relegated to the margins of society. I read Robinson at night. It was a bit hard to get to sleep after reading some of his stuff, but not impossible. Reading Barbara Ehrenreich and other non-fiction writers of her ilk is an entirely different story (no pun intended). Last night I finished reading her book Natural Causes: Life, Death, and the Illusion of Control. This book is firmly planted in reality. Problem is reality sucks sometimes. Ehrenreich is especially blunt when she writes about aging. Getting old is no cake walk. It’s not for the faint of heart although in our culture it’s not cool to ‘give in’ to the infirmities of age. Ehrenreich writes:

“But as even the most ebullient of the elderly eventually comes to realize aging is above all an accumulation of disabilities, often beginning well before Medicare eligibility or the arrival of the first Social Security check. Vision loss typically begins in one’s forties, bringing the need for reading glasses. Menopause strikes in a woman’s early fifties, along with the hollowing out of bones. Knee and lower back pain arise in the forties and fifties, compromising the mobility required for “successful aging.”” (from “Natural Causes: Life, Death and the Illusion of Control” by Barbara Ehrenreich)

And:

“Not doing anything is the same as aging; health and longevity must be earned through constant activity. Even the tremors of Parkinson’s disease can be seen, optimistically, as a form of health-giving exercise, since they do, after all, burn calories. The one thing you should not be doing is sitting around and, say, reading a book about healthy aging. There are bright sides to aging, such as declines in ambition, competitiveness, and lust.”*

So, we must always put a happy face on adversity, be positive about everything, and keep moving. I don’t think my nine hours a day sitting with my computer on my lap would be morally acceptable. But you know what? I’m finding it a wee bit difficult to feel positive about dying. A Cumberland friend, Howard Jones, who died recently spent his last few days in the hospital. He couldn’t breathe on his own much anymore. Months ago, over coffee he confided that he didn’t know how long he could continue on oxygen with a life very much reduced to sitting or lying in bed. He could no longer walk in his beloved forest. I meant to visit him in the hospital when I was there for my usual chemo treatment, but I was cautioned not to because of my compromised situation. I should have gone anyways. Now it’s too late. We did text each other, but that’s not the same as a face-to-face visit. One day, the day he died as far as I know, he was the one to make the decision to go off oxygen, thus ensuring his death. I think that Howard died a good death. 

The especially difficult decisions I know I will face in the near(ish) future will be whether I continue with the chemotherapy that has so far kept me alive. I will be thinking of Howard when the time comes. I expect that my (and my family’s) decision will hinge on the quality of life my treatments are now offering me and the intensity of their side effects. There is a question of how much benefit a few months of life can give in the face of much reduced quality of life. It will not be an easy decision. I love life, I love my family, my community and where I live. I am loathe to give that up, to know that the world will carry on without me. But it’s not like I or any of us have a choice in the matter. We all die. Some of us, however, are given the privilege of deciding when and how we die. 

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*I’m reading Ehrenreich as an ebook on a Kindle. The problem with that is that when I select a quotation to use on my post, it doesn’t give me a page number. I find that unacceptable and will see if I can find a work around. 

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.

The Kindness of Evolution.

Lately I’ve been reading books by Kim Stanley Robinson. He’s a contemporary science fiction writer who ranges freely into dystopia and utopia. I first read his Mars Trilogy and I’m now following that up with New York 2140. Imagine New York fifty feet deeper in water than it is now. Half the buildings in Lower Manhattan are partially submerged and roads are now canals. Flooding has not stopped the rapaciousness of capitalism, however, which has gotten worse in the next one hundred years. It may just get its comeuppance though. Robinson’s work, although not high literature, is prescient in my estimation and is a fun read.

Most people would consider the drowning of coastal cities a disaster, and it undoubtedly is, but we don’t have to wait until 2140 to find out what coastal flooding can do. We’re getting a taste of it now. We’re also getting a taste of what fire can do as well as tornadoes, hurricanes, volcanoes, etcetera. Reading the news these days, and you’ll be introduced to fires in British Columbia, dams bursting in China, and floods ravaging Germany. So, disasters are not uncommon, and the News media are only too happy to tell you all about them. 

Still, we don’t seem to be able to get prepared for natural disasters so as to mitigate the worst of the damage they cause. Recently, Angela Merkel, the German Chancellor, opined that they would have to do better in the future regarding disaster preparation. I might note that disaster preparedness is only going to happen if there is money to be made in doing it. That may seem cynical, but history bears me out, I think. 

One thing we have to recognize is that there are many kinds of disasters, and they don’t all unfold at the same rate. A volcano usually happens at a very fast pace, but climate change, which must be considered a high magnitude disaster, unfolds are a glacial pace although some of its effects unfold as quickly as any natural disaster because, in effect, that’s what they are.

Something very interesting about human psychology is the surprise or denial we all experience in the face of disaster. Flooding? Well, we didn’t expect that now did we. Cancer? Surprise, surprise! Why me? Climate change? Nah, it ain’t happening. 

Robinson has an explanation for our reactions to disaster or catastrophe:

“…you can’t really imagine a catastrophe will hit you until it does. People just don’t have that kind of mental capacity. If you did, you would be stricken paralytic with fear at all times, because there are some guaranteed catastrophes bearing down on you that you aren’t going to be able to avoid (i.e. death), so evolution has kindly given you a strategically located mental blind spot, an inability to imagine future disasters in any way you can really believe, so that you can continue to function, as pointless as that may be. It is an aporia, as the Greeks and intellectuals among us would say, a “not-seeing.” So, nice. Useful. Except when disastrously bad.” (from “New York 2140” by Kim Stanley Robinson)

So, Robinson argues that natural selection has kindly provided us with a “strategically located mental blind spot” when it comes to disasters, including death. Death for all of us is the ultimate, unmitigated disaster, but we deny that it’s coming, or we just turn the other way and hope for the best. We just can’t believe or accept that a disaster is happening. I expect that other species have much the same reaction to disaster that we do. It would be impossible to be anticipating disaster all the time. As Robinson points out above, if that were the case “you would be stricken paralytic with fear at all times”. 

As Robert Sapolsky notes in Why Zebras Don’t Get Ulcers*, zebras are stricken with fear when they are chased by a lion, but if they avoid getting killed, they return to grazing on the riverbank as if nothing had happened. Humans, on the other hand, can imagine future catastrophe, but not in a way we can really believe. For example, as I drive down the highway, I don’t expect that around every curve an oncoming car will skid into my lane and crash into me head-on. If that were the case, I think I’d have to give up driving. Same goes for death. If I thought about my death every minute of every day, I would be unable to function in life. 

Thanks to evolution, we have a “mental blind spot” when it comes to catastrophes and disasters. Life would be impossible without it. Still, we must deal with the generalized anxiety that the possibility of disaster engenders, hence our proneness for getting ulcers and/or visiting psychiatrists.

*Sapolsky, Robert. 2004. Why Zebras Don’t Get Ulcers, New York: Henry Holt.

The questionable quality of longevity.

Lately I’ve been reading books from the 90s. The books by Kim Stanley Robinson, especially the Mars Trilogy are, not surprisingly, set on Mars and span a period of several hundred years. It seems Robinson is not inclined to write about earthly events and characters, focussing his attention instead on Mars, her moons, and the asteroid belt that he has also transformed by technology to support human life. The book of his I’m currently reading is called Aurora and is about the travels of humankind outside the solar system for the first time. Their destination is the Tau Ceti e system some twelve light years from the Terran Solar System. It takes them many generations and 170 years to get there, a scenario packed with angst about life and death.

In an earlier work, Robinson confronts mortality straight on. He concludes about the characters in The Mars Trilogy that:

A long life is not necessarily a good life.

Their lives were long, very long indeed if they took “the treatment”. They could not yet know just how long they could live because few of them had died of causes relatable to an ordinary life, of ‘natural causes’ not that they were invincible. It’s true that most inhabitants of Mars were over two hundred years old. Two had died in an explosion, one had died by violence, another by being swept into a roaring river of ice into the depths of a swift moving glacier. In his Mars Trilogy Robinson has cleverly endowed his protagonists with very long lives. However longevity does not equal high quality and death will not be denied.

“There were all kinds of madness, evidently. Ann wandering the old world, off on her own; the rest of them staggering on in the new world like ghosts, struggling to construct one life or another. Maybe it was true what Michel said, that they could not come to grips with their longevity, that they did not know what to do with their time, did not know how to construct a life.”

from “Blue Mars (Mars Trilogy Book 3)” by Kim Stanley Robinson.

Mars colonists may not know what to do with their two hundred or more years of life. What about us? How do we decide what to do with our lives? How do we construct a life whether we have a month left to live or two hundred years?

This is really an unfair question given the vast range of possible answers along a plethora of trajectories. But it’s a question that can generate some critical thinking about our lives and how we live them. For that reason I feel justified in asking it. Still I think that narrowing the focus of the question could be valuable.

The questions that interest me the most concern our relationship with death and immortality. These are ‘intellectual’ questions that have nothing to do with the material requirements of life. Of course, no matter how we look at it, life means movement. Death implies stillness. That may be why so many of us are gripped with the need to do…something…anything. Doing justifies living. Stillness or inactivity reminds us of death.

Me at a very young age. Don’t know exactly how old.

This photo is of me at a very young age, not sure exactly how old. That said, I am not the person you see in the photo. In fact, although arguably I am the person depicted in this photo, I have very little in common with that person. I could say that in the photo you see an embryonic version of me and that may well be true. We, the little dude in the photo and I, are obviously related; we share a life trajectory. But there is not one molecule in my body now that existed in the little dude back then. And the little dude hadn’t read Marx or Darwin. According to Milan Kundera in Immortality little dude would be in the happy first stage of life. The second stage is the preeminently active stage when we realize that death is real and that it is hounding us. To fend it off we must do, build a career, a family, a community. The trajectory in this stage is characterized by growth and the morality of the time expects material production from us. I am in the third and final stage of life, or at least I can be found transitioning into the final stage, the WTF stage, I call it. It’s the stage when strength is fast being replaced by fatigue and exhaustion. Kundera writes:

“Fatigue: A silent bridge leading from the shore of life to the shore of death. At that stage death is so close that looking at it has already become boring.”1

I’m bored, but only to tears, not to death. I’m just now standing on the crest of the bridge but I can easily make out the shore of death on the horizon which is becoming clearer and more distinct every day. According to Kundera, this third stage is where freedom can be found. If I knew what freedom was I might be more eager to actively pursue it. The third stage will come or I will die in angst fussing over the quality of my life experiences and my immortality which, of course, can only exist after my death.2

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1 Kundera, Milan. 1990. Immortality. New York: Harper Perennial. page 71.

2. Kundera considers immortality as that view that encompasses an entire lifetime but is also restricted to it. It is a fixed entity that has no place except in the memories of those left behind. It is not soul based unless you can think of the soul as the totality of what we leave behind. It is not eternal life but the memory of a whole life lived. Death completes my life.