(Copyright © 2009)

Medical care seems centered more on appointments than patients these days. Without an appointment you are without care, it’s as simple as that. You have ten minutes to state your symptoms. Hello, my name is Thursday at 8:15. Administrative concerns are driving patients right out of the system. Who cares about patients? The wellbeing of the system is all. That’s how it feels.

I have had three or four bouts with a dermatologist this past winter. Each time I’ve walked out of his office with names of new salves, lotions, ointments, emollients to buy and rub on my body—all to no effect. I bought two humidifiers to raise the water content of the air in my apartment, which made lots of noise 24 hours a day, but didn’t ease my eczema.

I asked what caused my rash. The dermatologist said he wasn’t sure. I asked what eczema was, and he said blood vessels under the skin get inflamed, making the skin red, hot, and itchy. Why do they get inflamed? He couldn’t say.

What he did know was how to prescribe expensive chemicals to rub on my body in an effort to treat the symptoms if not the cause of my trouble. It all sounded like peddling snake oil to me. One prescription for VANOS(TM) 0.1% cream cost over $400 (medical insurance cutting my cost to $92). This was to temporarily reduce the symptoms without curing the underlying cause. But the precautions that came with the prescription read (in tiny, tiny type) partly:

General: Systemic absorption of topical cortico-steroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for glucocorticosteroid insufficiency after withdrawal of treatment. Manifestations of Cushing’s syndrome, hyperglycemia, and glucosuria can also be produced in some patients by systemic absorption of topical corticosteroids while on treatment.

Patients applying a topical steroid to a large surface area or to areas under occlusion should be evaluated periodically for evidence of HPA-axis suppression. This may be done by using cosyntropin (ACTH1-24) stimulation testing. Patients should not be treated with VANOS(TM) Cream for more than 2 weeks at a time and only small areas should be treated at any time due to the increased risk of HPA axis suppression.

With a history of skin problems (I have celiac disease which showed up as a persistent rash that lasted for years), I told both the pharmacist and dermatologist I felt I would be an idiot to spread that stuff on my body. The pharmacist said it was the accepted treatment for eczema, and had been for 20 years. He wouldn’t take it back.

In the end, with help from Wikipedia, I cured my eczema by myself. When first diagnosed, I’d looked eczema up and found that entry shed no light on my problem. But after seven months I tried again, and found the whole section had been rewritten and greatly expanded. Reading through it, I found a passing mention that nuts could cause a skin rash diagnosed as eczema. Allergic to peanut butter, I had taken to cashew butter, but at $10 a jar, I looked for something cheaper. A pound of unsalted, organic cashews cost $3 less, so I went for those. During the winter, a pound lasted me a week and a half. In seven months, I accounted for a heap of cashews. So the instant I read that article in Wikipedia, I gave them up. In three days my rash was gone.

What does this sad little story have to do with consciousness? It highlights the difference between my consciousness of living with a painful rash night and day for over half a year, the pharmacist’s consciousness of making a living from the suffering of people like myself, and the doctor’s consciousness of being a go-between with the pharmaceutical industry on one hand and the suffering public on the other, a public whose symptoms he is happy to treat, as long as they meet him on his terms in his office and don’t pester him between appointments. Me, I felt like a rat running an electrified maze to see how long I could stand the shocks.  

It is my nature to try to understand why things are as they are. To me, eczema, God, the universe, and human consciousness are all the same: mysteries to be investigated and—as far as possible—understood. I don’t know very much about any one thing, but I do have an inquiring mind. And once I get on a case, I stick with it until it makes sense to me. Everything that runs through my mind for whatever reason is an opportunity for greater understanding. Even the quirks of my own body and mind. Especially the quirks of my own body and mind. I am the single aspect of the universe I have the best opportunity to observe, and through observation over a long enough period of time, to understand.

I had a somewhat similar experience with an earlier rash that claimed my body 20 years ago. I went through the same routine, going to various doctors, finding a dermatologist in Bangor, rubbing an assortment of lotions and ointments on my skin—all to no avail. My rash had a will of its own. After years of ineffective treatment, the dermatologist removed a chunk of skin for a biopsy, and the diagnosis came back: Dermatitis herpetiformis. What causes that? An irritant that collects in the skin. And that was it. Now I had a fancy name for my ailment. To learn that secret Latin name cost me three thousand dollars, the price of joining the fraternal order of jackasses. But as an initiate I got no privileges beyond the right to flaunt those two words.

Which paid off ten years later when I got access to the Internet in 1997, the Web was being developed, and search engines offered the perfect interface between jackasses like me and those in the know. Working part-time for the National Park Service, I had a computer on my desk. When that computer got connected to the Web, I typed the magic words into NetCrawler—which hooked me up to a site at St. John’s University that said in effect, Dermatitis herpetiformis is caused by celiac disease, and celiac disease is an immune response to the gluten content of wheat.

I’ve been gluten-free for 12 years now. Ingesting gluten caused the villi in my intestine to lie flat so they couldn’t absorb calcium (among other minerals and nutrients), which caused all kinds of havoc in my bones, teeth, and nervous system. The human brain runs on calcium ions crossing membranes in every neuron, making action potentials possible, letting the brain get on with its work. Until I was sixty-five—the year I retired—my brain never worked as I wanted it to. I had inklings what it could do, but it just laid down and died when my expectations were too high.

Is it any wonder why I put my working brain out in full public view on the Web in this blog? I have used the Web twice to find answers to serious problems. There are answers to be found if you hit on the right source. It took me a lifetime to find that out, so now I’m trying to shorten the wait in regard to questions about consciousness that introspection can explore. Not that I have answers, but I do have a drive to pursue questions, and I’ve still got some days of hot pursuit in me yet.

As I see it, the world is not so much a monument to humanity’s great accomplishments as it is a great big question mark. And our job is not to flaunt how great we are but to get down to the hard work of answering important questions—especially those nobody has thought to ask till now because they weren’t in a position to ask. Such as diagnosing and treating the world’s ills, which are becoming more evident every day.

If our numbers and appetites are a problem not only for ourselves but for Earth itself, we’ve got to do something about them. I don’t see us making any headway until we ask the right questions in the right way in the right place. I am here to suggest that all problems that evade conscious scrutiny will remain problems until we engage them deliberately in full-frontal conscious investigations and deliberations.

If the narrow scope of human consciousness is the problem, then the solution depends on expanding the reach of consciousness until it embraces our human activities and impacts as a whole. One thing I am sure of, collectively we and our ways are the source of the problem. Until we can consciously deal with our unwitting complicity, we are shielding ourselves from questions that need to be asked.

Consciousness begins with a good challenge—a good question. After that, it will serve us well as long as we stay focused. Our cultural witch doctors can’t do our work for us. Let us examine ourselves firsthand so we can find our own cure!

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(Copyright © 2009)

 

Pain is an advisory that something is wrong and needs to be addressed. Sometimes it’s more a word to the wise—it would be best to avoid similar situations in the future. It is such a bummer because the message arrives after the damage has been done (Don’t break your neck again!).

 

Even my 14-year-old car can do better than that. It has gauges, warning lights, and a buzzer that signal me about leaving my key in the ignition switch, oil and gas levels, engine temperature, electrical system, doors that are open, air bags, and seatbelts—all of which, if annoying, are not painful. If we could bring out a new model of the human body, I’d recommend making some revisions to the pain-perception system along the lines of warning signals like these.

 

What led me to blog about pain as an aspect of consciousness is that it’s been keeping me awake for a week now, and last night almost did me in when three sources of pain converged all at once. Last November I wrenched my side taking my boat mooring out of the water, and have periodically felt sharp pains shoot between my pelvis and groin. Since about the same time I’ve had a serious itch from my neck to my knees, perhaps a kind of eczema brought on by central heating in an unusually long and cold winter. Then about a week ago I twisted my leg, bringing on separate pains in my right rump, thigh, and shin.

 

For a week I’ve run through a Kama Sutra of sleeping positions, trying to find the magic posture that would calm all three pains at once. But it eluded me, so I’d flinch here and flex there to fine tune my discomfort—which always made it worse. Turning to find relief that never came, I kept winding the sheet and blanket around me, so I’d get up and remake the bed. After polishing that routine three or four times an hour, I looked at the clock and found I’d been thrashing around for six hours and still hadn’t gotten to sleep.

 

I’m pretty earnest about managing my troubles, so put my whole self into finding some solution to the problem. When I couldn’t, I felt like Job and his boils, or a tortured figure by German painter Mathis Grünewald. “Why me?” turned to “poor me,” and I just sat in the dark heaving from my exertion, utterly defeated.

 

It wasn’t only the pain but my added emotional response to being wholly thwarted in finding a way to beat it that brought me to the brink of what little sanity I had left. If there was a switch in my pain circuit, I’d just check now and then to see if it was still there—like checking the oil in my car. But that isn’t how pain consciousness works, so I’m stuck having to listen to a klaxon raging in my head with no way of shutting it off. In childbirth, at least you’ve got a baby to show for your pains.

 

In a vending machine at the laundromat this morning, I saw the headline on a story about a woman with rheumatoid arthritis: “Prevailing over PAIN,” the last word printed in red. I’ve never had serious pain like that. Mine has always come from wear and tear, with a few hard knocks now and then. After writing about my sleepless night, other painful experiences began cropping up. Like the time I wasn’t paying attention and pounded my thumb instead of the roofing nail I was aiming for. That wasn’t so bad because the sore thumb paled besides having a new roof.

 

I had a long bout with bursitis from carrying a heavy tripod on my left shoulder for several years. The exercises I did for that were worse than the bursitis because I had to push into the pain to get beyond it. Fifteen years later, I wrecked my neck on the same side by seating the shaft of the hydrophone I was using to track horseshoe crabs always in the same place, the crook where neck muscles attach to the shoulder. After two years of listening for sonar signals from a moving boat—the shaft driven into my neck the whole time, I couldn’t turn my head without severe pain. It took three years of exercising every day to free up my neck. In both these instances, I never felt a thing until the damage was done. Then the pain came on to remind me what a fool I’d been.

 

Dreaming of entering the Boston Marathon played out as much the same story. I got up to running eight miles a day, but then my left knee told me it had other plans. The knee was so painful, I took five minutes in easing my way in or out of a car. I limped with a cane for several months, but the knee healed itself and that was the end of my brilliant racing career.

 

Which reminds me of the year I walked on a bum foot, and took two aspirins every four hours to manage the pain. Another dumb cluck story. I was a part-time employee at Acadia National Park in Bar Harbor. Helping to set up an office for the Maine Acadian Culture Project in Madawaska, I hefted the downhill side of a bulky, steel storage cabinet up the stairs, and next day had shooting pain along the sole of my left foot. Which didn’t go away. I went to a foot doctor (a charlatan it turned out), who said the pain wouldn’t last. But it did. So, on my own authority, I adopted the aspirin routine. The pain did go away, but only after a year. In the interim, I developed a sensitivity to salicylates, which are in almost everything we eat. As a result, variety in my diet has been much reduced even beyond the severe restrictions imposed by celiac disease.

 

The next time I felt the same pain—after lifting my boat onto a platform to get it above the tide—I went to the other foot doctor in town, who said I had plantar fascitis, which he treated effectively in a matter of weeks.

 

Like sight, smell, or hearing, pain is a percept, a sensory experience, often enriched by emotional overtones. Similar to senses of touch, pressure, temperature, or position, it arises from receptors distributed throughout the body, in this case producing an unpleasant sensation warning of danger, physical injury, or organic malfunction.

 

Too, pain can affect different people with different backgrounds and sensitivities in a variety of ways. Some appear to be more tolerant to it than others. But in every case, pain is a significant aspect of personal consciousness. By way of proof, inquire of yourself about the role and significance pain has had in your personal life. Your memory may not respond right away because memories of uniquely painful experiences sometimes get archived. But in time they will come back, recall of one opening the way for others.

 

One thing is clear: your pain is your own. You feel it, others don’t. Nor, other than in a compassionate sense, do you feel theirs. I had a teacher once who doubled up upon sneezing. Recovering, he told the class, “Now I know what childbirth feels like.” Not very likely. In giving birth, every woman creates her world all over again. Which, as far as she is concerned, is the world, the only one she knows. Men may assist at childbirth, but afterwards, though awed or excited, they go on much as before with no sense of what it would take to push a grape—much less a grapefruit—between their pelvic bones into the world.

 

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Reflection 89: My Day II

April 13, 2009

 

(Copyright © 2009)

 

Yesterday I wrote articles for Friends of Taunton Bay Newsletter. Today I was going to start writing a new post to my blog right after breakfast. First, though, I had to do laundry. Which I did. But taking clothes out of the washer to put in the dryer, I noticed a blue film on the base of the rotor. What’s that? says I, testing the film with my finger. Wax. A layer of blue wax. I knew immediately what it was, and where it came from. I have dry skin, so to avoid itching, I rub an emollient on my chest, arms, and legs to soften the skin and preserve body moisture. One of the ingredients in the emollient is microcrystalline wax. Which gets on my shirts, pants, and T-shirts. Into the wash. Onto the rotor. Where it will stay until I find some way to remove it.

 

I have written in earlier posts that consciousness is given us as a means of dealing with unprecedented situations by turning issues of experience into appropriate behaviors. That is, to solve problems, if not verbally, then through relevant actions in the world. Well, here was a situation I had never been in before in my life. I live in town housing and share laundry facilities with over 90 other people. Who wants to load laundry into a washer coated with blue scum?

 

What to do? I ask at the desk for Tim, the maintenance man. He’s not in today. Then I’d like to talk with someone else. Through the door, I see John, who used to be the maintenance man but has a new job. Can I speak to John, please? He comes out and I tell him what happened. He tells me to put an “out of order” sign on the washer. I tell him I’ll go on line to search for something that will remove wax. Which I do—both make the sign and do a search for wax removers. First scrape off as much as you can, I am advised. Then clean with rubbing alcohol, denatured alcohol, dry cleaning fluid, or WD-40. I have WD-40, but can’t see myself spraying it inside a washing machine. I’ll go to the drug store and buy some rubbing alcohol. First, I scrape as much of the wax as I can with a dull knife. Which takes a while because it’s hard to see and get at the vanes on the rotor.

 

Of course it is snowing. The temperature is 33 degrees, but the snow isn’t supposed to turn to rain until afternoon—another four hours. I put on parka, hat, gloves, and head out. Sidewalks are coated with snow and I keep losing traction. I practice my winter one-step, which requires full attention, so I make slow progress. First to the grocery store, but I find only booze, no rubbing alcohol. Then the drug store, which claims to be open, but only partly, because it’s being remodeled. I creep to the other drug store, which has rubbing alcohol, 75% or 93%. I go for the 93%. Because of my celiac disease, I avoid contact with alcohol. I need rubber gloves. Back to the grocery to buy gloves. Then home.

 

Only to discover the washing machine churning away. I think it’s another resident making a statement by ignoring the “out of order” notice. Turns out it’s John, running a dilute solution of alcohol to dissolve the wax. Which it doesn’t.

 

While the washer is going, I check my e-mail and tend to several tasks I have under way. Which takes more time than I expect. When the washer stops, I get paper towels, pour out rubbing alcohol, and apply elbow grease. Which works, but not very well. John removes the nut holding the rotor in place, so I lift it out and scrub away. First the base of the rotor, then the vanes, then the stem. It takes almost an hour. I put the rotor back, and run an empty load with heavy-duty detergent. That ought to do it.

 

But I still have a problem. How am I going to do my laundry? The rash I get from dry skin hasn’t gone away. The microcrystalline wax controls it, but doesn’t cure it. I can’t go through this every time I need clean clothes. So far so good. I’ve solved the immediate problem. That is, consciousness has dealt with the novelty of the situation and gotten me this far, but I have no idea what to do next time I need to do laundry.

 

I haven’t been to the dermatologist for two months. I call his office and make an appointment for next Tuesday. Maybe he’s seen patients in this fix before. Beyond that, I wonder about disposable clothing I can wear and throw away. About not wearing clothes at all. About wearing worn clothes I was going to throw out anyway. About wearing yucky clothes coated with wax. For the indefinite future—maybe forever. Time to work on something else before I go batty.

 

It’s one o’clock—an entire morning wasted, my concentration spent. The only thing left to me is to write a post about how consciousness saved half the day at least. I wrote a post called My Day on November 4th—Election Day 2008. I’ll call this My Day II. Then I’ll make dinner, answer e-mails, and teach my adult ed class on The Great Outdoors at the high school. Consciousness under control of normal expectancy, that’ll make my day feel less hectic than it has been up till now.

 

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