@sex

Myeloma, Sex, and Dementia

~ Roger JG Albert ~ 3 Comments

October 30, 2022

I hope you’ll forgive me if I’m not my usual chipper self today. I was in the Hospital again for a few days starting on Tuesday morning the 25th. On Monday afternoon I got radiation treatment on my back and right femur. That evening and especially during the night, I developed a high fever and once again I ended up on the floor in our hotel room unable to get back into bed. Paramedics came and they got me back into bed. They had to come back later to take me to Royal Jubilee Hospital in an ambulance. That’s the fourth time I’ve ended up in Emerg with a high fever after a treatment for myeloma.

The radiation oncologist at the BC Cancer Centre assured us that the radiation treatment had nothing to do with the high fevers I got on Tuesday after the radiation treatment on Monday. I have no reason to doubt her, except that it’s hard to deny the pattern here. It seems that every time I get a treatment for myeloma my temperature spikes and I end up in Hospital getting massive doses of antibiotics and other meds. I can assure you, though, that it will not happen again because I will not get any more treatment for myeloma, not chemotherapy, not radiation. It’s just too hard on me. My gut gets squirrelly, unsettled is too weak a term for how my gut feels. It’s still messed up and it’s Sunday. I can only hope that it gets better. Hope is all I have left. [It is better -Tuesday]

October 31st, 2022

I don’t mean to gossip, but my stay at the hospital this past week was replete with drama. Emergency Departments these days often stand in for family physicians. People with minor ailments are stacked in waiting rooms while often more seriously ill or injured patients are made to hold up in ‘rooms’, (that is curtained off areas) that are tiny. It’s possible to hear everything that goes on in these ‘cubicles.’ When I was taken to the hospital by ambulance on Tuesday 4:30 AM or so I was immediately introduced to the maelstrom. After a short time I was wheeled into a room that is set up for two patients. Carolyn was with me. We could hear everything that was going on in the area centred on the nurses’ station.

Enter a screamer. Make that an old screamer. She is eight years older than me but assailed by dementia. We eventually learned that she had fallen and broken a femur. She must have been in a lot of pain and she made it very clear to everyone within earshot that she was highly distressed. Initially, she was wheeled into the maelstrom, then for some reason the staff moved her into the room I was in. She screamed “Help, help!” over and over again, even if there was a nurse in the room. Then she would yell “No, no, no, no, no!” This went on and on and on at well over 100 decibels. I am not blaming this poor woman. She was in pain and she has dementia. But, man, did she have a set of lungs too. Every once in a while we’d hear a patient yell from across the room: “Shut up! People are trying to get some sleep here!” That didn’t slow her down at all.

November 1st, 2022

Finally, they got me into a ward on the 8th Floor of the hospital. That happened sometime after 11 PM on Tuesday. At the North Island Hospital in the Comox Valley I ended up on the 3rd floor a couple of times, in the same room too. It’s a large room for one patient. In the Royal Jubilee Hospital in Victoria, I was wheeled into a room set up for three patients. When I arrived, it was already occupied with two patients, a young man probably in his twenties, and an older man. Not sure how old he was. During my stay there I didn’t talk to the other two patients in the room, not once. The older guy was very ill and demented. He screamed most of the time, often at the top of his lungs, much like the screamer in Emerg. The nurses told him on more than one occasion to be quiet and the care aides admonished him periodically to “be nice to us.” He was not nice at all. He swore at everybody and wondered aloud why people were in his bedroom. He was most unpleasant, but I can usually tolerate people in his situation.

What can I say about the kid in the third bed. He was young, he could move around, and often went to the bathroom. I’m not sure why he was in the hospital, but I know that he was visited periodically by someone working on mental health and addiction issues. On my last night there, two young women came to visit this guy. They arrived around 7:30. One of them left around 9. The second one didn’t leave until 1 AM. You can draw your own conclusions about what happened behind the curtain separating his part of the room from mine, but it brings to mind a certain Paul Simon song. I know, it’s unbelievable but it did happen. It’s a good thing I had earplugs, because I still detected the odd moan and groan through the curtains. The nurses must have known she was there, but nobody did anything about it. Interesting. Not something I expected to experience in a hospital. Always a first time I guess.

Things Change

~ Roger JG Albert

My last post was twenty days ago. I used to put them out every week, but things change.

When I started writing this blog in 2012, the year I retired from teaching at the College (NIC) I was focussed on working through my relationship with Ernest Becker’s books The Denial of Death and Escape From Evil. For me these books contained some profound truths about us humans, how we relate to life and death, how we organize our societies as competitions for God’s attention. It’s interesting that we created God as a projection of human values, a projection that we then use as a means of judging our actions to determine just how worthy we are of eternal life. We even, according to Becker and other cultural anthropologists, divided our social groups into moieties (halves) to set up the competitive structure by which we could establish winners and losers for God’s favour, which is nothing less than immortality. Countries and Nations are the logical expression of this thesis. 

We also, over the millennia, elevated man (that is, not woman) to the predominant social position. It took millennia to do that, but once the idea stuck, it got so strongly entrenched that it became normal. The idea that men were somehow superior to women infiltrated all aspects of culture. Women were, for all intents and purposes, relegated to slave status, gatherers of food, and bearers of children. The perfectly natural womanly monthly experience called menstruation where menses (blood and other matter) are released from the uterus was held against women. Blood reminds men of dying. When men fall in combat or by accident, they bleed and they die. Men don’t like that. So women bleeding regularly could not be good either. It is a huge reminder of death. So, many cultures isolate menstruating women, treat them with contempt and shun them. By extension, men could pretend that they were more ‘spiritual’ than women. Women were biological, men spiritual. Men were clean, woman dirty. This could not be more clearly demonstrated than in childbirth, a very messy and bloody process, proceeded by months of lessened capacity and followed by the need to nurture infants, a relationship of dependency that created an avenue for men to assert dominance. These tropes still survive to this day, in some ways stronger than ever. 

I’m still captivated by the ideas I gleaned from Becker, but after I was diagnosed first with pernicious anemia (in the 1990s) and then with multiple myeloma (in October, 2019) my focus changed, and this blog became a chronicle of my life with chronic pain and cancer. Old age, of course, plays a predominant role in my life, how I feel, and how much energy I can devote to any particular task. I don’t think anyone can understand the effects of old age on the body, energy levels and strength, until it becomes personal. I promised myself for decades that once I retired, I would do all the things I had no time to do as a working person. That was true for a time, but when I hit 70, things changed, and they continue to change. From now on I cannot expect things to improve. All I can do is adjust to my changing body with its lower levels of energy, suppleness, and strength. I think my mind is still capable of some surprises. That may be delusional on my part, but that’s fine. I guess I have the right to some minor delusions. 

So, I may be afflicted with cancer and old age, but I was trained in the social sciences and they still have a strong hold on my mind. I still think that we, as men and women, need to reconcile many powerful forces that dominate our lives. One of them is misogyny, the curse that lives deep in our psyches but is not based in biology. But what of basic biology? Well, let’s explore that a bit here.

At the end of my last post I said I would discuss penises and clitorises, so here we are:

Penises and Clitorises.

Most of us have one or the other. The fact is that they are very similar in structure and function. As the long quote below maintains, at the sixth week of gestation we all have clitorises. That’s not quite right. We all have a precursor to both the clitoris and the penis. That is, penises and clitorises arise from the same tissue in the early embryo. So, the pleasure men derive from penile stimulation is the same as women derive from clitoral stimulation. Depending on the chromosomal and hormonal environment we become either female of male, or both, or neither. To say that men and women are opposite sexes is profoundly misleading. We are not, as Alice Dreger so aptly points out in her book I introduce below.

For many years I studied love and sex and taught College courses on the topic just before I retired in 2012. It’s a truism to say that the sex act is a social act so it’s clear that we are social animals right from the start. Like for most animals, our sex lives and our social lives are strikingly interconnected. 

The pleasure we derive from intercourse, and especially from genital stimulation of any kind, including from masturbation, has profound social implications, but not all of us are capable of deriving pleasure from genital stimulation, the source of sexual pleasure. That follows from the fact that humans come in so many sizes and shapes. We vary in a hundred different ways including when it comes to our sexual organs. 

Before the sixth week of gestation (more or less) we are sexually undifferentiated meaning that there’s no way to tell whether an embryo is male or female. After the fourteenth week and the androgens kick in we begin to display our sexual organs. 

There is so much information available on this topic on the internet that I don’t even want to go there. A huge number of popular sites exist along with a large number of scientific ones. I just finished reading a (Kindle) book called Hermaphodites and the Medical Invention of Sex, by Alice Dreger (1998). The book explores the way things don’t always go as we expect in the womb. Yes, the vast majority of us either end up male or female, but that dichotomy isn’t as clear cut as it seems. A visual inspection of external sex organs may lead to the belief that a person is either male or female, but looks can be deceiving and it’s impossible to look inside the brain at the hypothalamus and the sexually dimorphic nucleus (SDN) to determine maleness or femaleness as the brain evaluates it. The quote below is from a popular website. It can give you some idea of what’s available now on the internet since Dreger published her book in 1998. It addresses a point I made earlier about our embryonic selves:

Everyone starts the same in utero.

What determines whether you’re born cis-male or cis-female are your XX or XY sex chromosomes. The XX pair is cis-female and the XY pair is cis-male. During gestation (the time between conception and birth), the genes on the sex chromosomes are expressed and the fetus becomes cis-male, cis-female, or (in some instances) intersex. These sexual differences are expressed as the penis and testes (cis-male), the vulva and vagina (cis-female), or some combination of the two structures (intersex).

However, in the first six weeks of a pregnancy, before the genes in these chromosomes are expressed, all budding fetuses actually begin as cis-female, meaning that everyone begins their development in the womb with a clitoris. (Wow, right?!) Then, one of two things happens due to “a low level of the hormone testosterone [being] released,” this structure grows into a penis, says Laurie Mintz, Ph.D. licensed psychologist, certified sex therapist and author of Becoming Cliterate. Or “when testosterone is absent, the tissues develop into a vulva (including the clitoris) and vagina.”*

[Check out this YouTube event for the experience of a transgendered man. Born a ‘girl’ he never fit in and was always a man in his mind: https://www.youtube.com/watch?v=nOmstbKVebM.%5D

So, enough for now. I still want to explore further the idea of sexual reproduction going back to early eukaryotic cells and the consequences for evolution of sexual reproduction. I also have a number of other related topics I want to explore along with continuing a chronicle of life with myeloma. Later.

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*https://www.shape.com/lifestyle/sex-and-love/genital-anatomy-penis-clitoris

Remembrances 2: Pornography

~ Roger JG Albert

I’ve just finished reading a book by Julia Shaw (Dr. Julia Shaw) who studied psychology at UBC. Her book is called EVIL: The Science Behind Humanity’s Dark Side. (Doubleday in Canada, 2019). Her basic premise in that book is that evil is entirely subjective and we all have evil tendencies within us and the potential to act on them. For Shaw, murderers and torturers, even Hitler, are human. They may have committed atrocities at times, but not 365 days a year, 24 hours a day. For Shaw, no one is objectively evil, not Ted Bundy, not Jeffrey Dahmer, not Paul Bernardo. Not even Hitler. She asks, provocatively, would you have killed baby Adolf if you had been given the chance? Her answer is, probably not because there would have been no way to predict how Hitler would end up on the basis of what he was as a one year old boy. For Shaw, evil is situational a great deal of the time and one person’s evil is another person’s glory. Ernest Becker declares in his book Escape From Evil that the twin pillars of evil are death and disease. He doesn’t objectify people as inherently evil. In essence, he argues, we have a deep-seated cultural aversion to death and disease and we have created a plethora of institutions dedicated to the denial of death and disease (including hospitals, I might add). Those institutions may be at loggerheads with one another as part of the ideologies of competing groups as they go about vilifying each other. But I digress somewhat.

Shaw deals with many instances of evil in the world, including pornography. Like all other themes in her book, Shaw doesn’t condemn people for watching porn, (and she doesn’t even consider it evil). She insists that people who watch porn are not evil, and are in fact, normal. This is true particularly considering that she argues from a 2007 study by Pamela Paul elaborated in her book Pornified (New York: Times Books) that “66 percent of men and 41 percent of women consume porn on at least a monthly basis.”1 When I taught a course in 2010 and 2011 at North Island College called Love and Sex and I did research on porn for the course, I learned that at that time 37% of the income derived online was from pornography. Of course there’s no way of pinning down a reliable statistic on the valuation of pornography, but it’s big business, there’s no doubt about that. Still, as Shaw argues, there is a gloss of shame and moral terpitude that accompanies pornography. Shaw is entirely correct here. In fact, I challenge you to admit yourself to viewing porn, or to have someone else you know admit to viewing porn. I wrote above that I researched porn for a course I taught at NIC in 2010-11. In doing that research, I viewed a lot of porn.

As people got to know that I was doing research on porn I got a lot of: “See any good porn lately, wink, wink, nudge, nudge.” That kind of comment was absolutely uncalled for with veiled suggestions that what I was doing was somehow immoral, but sex is such a powerful subject in our less-than-open society that even doing research on a taboo subject in any way associated with sex was liable to unleash opprobrium and displeasure. As part of my responsibility around this research, I notified the college that I was doing this kind of research and that they should be aware of that because it may show up on my computer. Shaw notes in her book that:

“When attempts at empathy and understanding are made, there is often a particularly vicious utterance that is used to shut them down; the implication that some people should be empathized with, lest we imply that we too are evil. Want to discuss paedophilia? That must mean you are a paedophile.” (p.8)

What I was especially interested in as I investigated porn was the way that women are portrayed by the purveyors of porn. I’m assuming that porn hasn’t changed much in the last ten or twelve years since I conducted my research, but I do know that there is a movement among some women to transform porn.2 In my research I noted that it was very common for women to be referred to as dirty, sluts, etcetera. Actually, I take it back. Porn has changed a lot in the last ten years. Just a quick scan of one porn site and it’s obvious that there’s a lot more DIY porn out there. It’s now common for young women to set up chats or performances of various sorts for money, and incidentally for the pleasure of men,I suppose. And, somehow, tokens have become part of the porn scene. I wasn’t going to get into how that works. Much on the DIY porn is ‘porn-lite’ but there’s still a lot of violent and nasty stuff out there with much denigration of women. It’s hard for me to relate to misogyny given that I had a mother, I have a spouse, many sisters, two daughters, and granddaughters. However, I know about the origins of misogyny in the Biblical story of creation and in many other cultural institutions and myths, and I see misogyny glorified in politics, education, movies, and popular programs like Game of Thrones, among many others.

Actually, porn is no different than many mainstream views on sex as dirty. Why the association of sex with dirt? Well, dirt, death. I’ll not go into this here to any extent. See this post I wrote from March, 2018 for a discussion: https://rogerjgalbert.com/2018/03/27/why-do-some-people-refer-to-sex-as-dirty/ Interesting that I seem to come back over and over again to these themes.

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1page 145 in Shaw’s book.

2see especially After Pornified: How Women Are Transforming Pornography & Why It Really Matters by Anne G. Sabo, a book I just ordered. (After I read Sabo’s book I’ll get back to you about how women are transforming porn.)