Friday, March 18, 2011

The Migraine In Spain Stays Mainly In The Brain

Some of you have been wondering why I’ve been posting so regularly when my final exams are just days away - Tuesday the 22nd to Thursday the 24th of March, to be exact. Surely I should be devoting this time to revising? Fact is, I always feel more creative when there are more Grown Up Things To Do like passing exams or rites of passage. (You should have seen the bad poetry that spewed forth when I got my mortgage approved.)

I think I 'm writing so much more  because my brain is full; and full of exactly what I don’t know. I hope I’ve absorbed enough facts to regurgitate into passable answers for the nine hours that await me next week. I’m drawn to rattling off blog posts probably in an attempt to disperse some nervous energy. My family know me well – when stressed, I can run around the house talking to myself like a Looney Tunes character, so blogging is probably a more socially acceptable option.

In case you were wondering, my mental state is, I guess, like all people facing a final professional exam – suitably miserable. For non-medical peeps, the College final is essentially your professional board exam in your specialty, once you have it and your four to five years of clinical postgrad training are complete you can register as a specialist.

Having said that, I’m strangely calm this weekend. One thing about an exam like this is that you can’t cram for it, it’s months of slow slogging, a very, very long bout of attentive reading. If I have one bit of advice to anybody attempting something similar is: SLEEP IS YOUR FRIEND. I’ve had to learn the hard way. Being a bit of a night owl, used to surfing the net and watching Cartoon Network till 2 am, insomnia crept up on me insidiously during the past year and – until day Iwas  looking and acting like a zombie from The Night of the Living Dead

And bad sleep is almost worse than no sleep. My wife has had to be a sergeant-major in forcing me to adopt a strict sleep hygiene regimen of regular hours (as far as is possible when one is doing night calls at least once a week) and taking “time-outs” to meditate. Even so it’s been necessary to supplement with pharmacological help. I dislike the idea of sleeping tablets but at the moment it’s the lesser of two evils. And then there are the migraines, that zoom to a bout of insomnia like flies to carrion. It’s always amazed me how something so excruciating ends up being temporary and – from what we know – harmless to the body in general. I always think I’m about to die. Even in their milder forms, my attacks (which are fortunately usually rare) feel as if a demonic pixie is water-skiing inside my skull, pulling on my optic nerve as it slices through the choppy seas of my throbbing head.

I can really sympathise with Francisco Goya, the great Spanish artist who, it is said, also suffered from crippling migraines. Many think that his darker, fantastic visions were painted during an attack, or at least inspired by the hallucinations that can sometimes accompany a migraine’s heralding aura. I’m particularly fascinated by Goya’s wonderfully nightmarish El sueño de la razón produce monstruos (The Sleep of Reason produces Monsters). It’s one of the 80 etchings entitled Caprichos  in which Goya “[condemned] the universal follies and foolishness in the Spanish society in which he lived.” (Wikipedia). I see him taking a jib at “civilised” society and demonstrating how reason is but a thin crust on top of a seething core of dark energy. (For those of you who might have noticed, I’m borrowing the term dark energy from astrophysics deliberately  – hmmm – that seems to deserve a blog post all by itself…)

Let’s look at the etching more closely. It’s considered a self-portrait, with Goya having fallen asleep at a table. A dark army of bats and owls, supposedly representing ignorance and foolishness, swirl around him menacingly. Is this a cautionary tale about the dangers of losing one’s grip on reality? Or, is it possibly a brutal reminder of the energy of the creative process?

Certainly in my case sleep (or rather the lack of it) has raised a lot of bats and owls of their own. Perhaps I could ask them to rather hover around my blog posts while the countdown to exams continues. Just for now. They can flock right back when I’m done and produce as much bad poetry as they like.

And now off to bed. I was last looking at a paper on the Cockroft-Gault equation for predicting a patient’s kidney function and that’s already enough for a full weekend’s supply of nightmares.

I hope you all sleep better than I do! 

Wednesday, March 16, 2011

Teuflische Schadenfreude

I'm furious and on my high horse. In the wake of the horrors that have struck Japan in the past few days, there are actually people out there saying "serves you right" to a nation reeling in shock. Just yesterday morning on the Gareth Cliff show some silly woman who evidently has tapioca pudding for brains proudly stated that the Japanese were getting their (ahem) just desserts because of their "cruelty". It of course never occurred to her that almost every other nation in the world has at some time or other been Satan's little helper in the treatment of their fellow man. Other fuckwits are intoning similar attitudes, citing Japan's whaling policies or ecological record as the cause of a monstrous karmic payback.

Of course. It makes such sense now. As if busloads of Japanese senior citizens go on daily dolphin-clubbing excursions. As if Japanese children are trained to be ninjas from kindergarten. Following this logic Spain should have been drowned by floods for the Inquisition. (The Rain In Spain, you see...) The Earth's very crust would by now havbe exploded open and burnt Great Britain to a crisp to atone for the evils of colonialism. Germany would be toast. Why, South Africa must be on constant astronomical watch for that giant meteor that's going to impact on Orania, any day now, to pay for the atrocities of apartheid.

Humanity would have ceased to exist millennia ago if there were a blood debt to be paid for all the things our species have done to the Earth and to each other. The Universe, fortunately in this case, has bigger cosmic fish to fry. Spare a thought for the cosmos; it must be exhausting keeping the total amount of energy in your system absolutely constant. That said, it must be even more exhausting to find pleasure in other people's misfortune.

The Germans have that wonderful word, schadenfreude. The philosopher Artur Schopenhauer is famous for his statement,  "Neid zu empfinden, menschlich, Schadenfreude zu genießen, teuflisch." (To feel envy is human, to enjoy schadenfreude [joy in the suffering of others] is devilish.) Unfortunately we're all guilty of it. Note that Schopenhauer says the evil is specifically in enjoying our pleasures in others misfortunes - who hasn't rubbed their hands together in glee when misery overcomes our enemies? I would go as far as to impose a statute of limitations on Schopenhauer's statement - sorry, but, wouldn't many of us be happy to be teuflisch to see a child molester deep-fried in oil or a rapist's offending bits be cut off slowly? It's very hard to live up to the teachings of the great religious figures to submit our rage and ego to a higher power. But I'm still shocked that people like that caller could paint with such broad brushstrokes.

Then there's the case of Christopher Hitchens who is dying a painful death from cancer. He's a prominent atheist, the author of the bestselling God Is Not Great: How Religion Poisons Everything. And there are people calling themselves Christians who are delighting in the fact that he has cancer. They see it as divine punishment. I bet they're just waiting for Richard Dawkins to get crippled by some awful degenerative disease. It freaks me out how these so-called Believers can get so drunk on self-righteousness that they wish a fellow human being a painful death... while at the same time espousing a religion of peace and love! Ironically, they're furthering Hitchens' cause by making the theists look bad. It almost makes me ashamed to say that I believe in God. Almost. Until I realise that we're obviously not believing in the same God.

Verily, man creates God in his own image. Perhaps some of us feel the need to rain down righteous anger because we have a pathological need for order. We crave answers.
We ask, "Why Japan?"

If the Universe replied "because they deserve it" we'd have a reason not to worry any more. It would be so much easier.

But the Universe always replies the same thing to every question: "Why not?"

Why not indeed? So - to try and attempt to turn the other cheek as it were, perhaps these people who would assign blame around every corner need love and understanding.

Then again maybe they're just assholes and I'd love to have them go through all the horrors that the people they condemn have endured...

Oops. Schadenfreude.

Sunday, March 13, 2011

No Greater Sorrows

There is a wonderful scene in the film Nell in which Jodie Foster’s character is the subject of a hearing to decide whether she needs to be institutionalised. (Nell is a woman who has grown up in a remote wooded area with no human contact apart from her disabled mother, who has a severe speech deficit from a stroke. As such Nell speaks her own unique language and has difficulty integrating into society after she is discovered by authorities after her mother dies.) A doctor (played by Liam Neeson) who has learnt to communicate with her, acts as her interpreter. In exhorting the review board to let her be and let her live her life contentedly as before, Nell urges:

Don’t cry for Nell… I have no greater sorrows than yours.

I’m aware that the words “Don’t cry for [me]” are already famous, but I’m definitely not wanting to evoke images of a certain Andrew Lloyd Webber musical. I’m referring to our clumsy capacity as human beings to confuse sympathy with empathy.

The doctors and psychologists and social workers argue that Nell is emotionally traumatised and socially retarded, needing specialised care. They see Nell as a problem to be solved. The wolf-child, as it were, who must be civilised. And not gently either. Granted, the film is deliciously manipulative in showing us Nell living a life of Arcadian seclusion in the stunning wilds of the Pacific Northwest. But the film doesn’t paint the establishment as a totalitarian regime either – indeed, Liam Neeson’s character is a down-to-earth, strait-laced GP who acts as a bridge between Nell and the outside world. Nell’s character is lucky, because we have a Hollywood ending. In reality she would have ended up at best as a “special needs” social case and no doubt as someone’s PhD thesis. Yet her exhortation to her would-be “protectors” haunts me: I have no greater sorrows than yours. So don’t feel sorry for Nell, don’t cry for her. Try to understand, yes. Co-exist, yes. But that is, we know, so much trickier than “solving” a problem.

Clashes between worlds are inevitable, but I think the reasons can differ. Evil aside, often we act out of fear, sometimes out of sympathy; I put it to you that results can be similar: tragic. The road to hell isn’t paved with good intentions for nothing. Sympathy is all too often clinical; when faced with someone in circumstances other than our own, we convince ourselves that we can feel the same things as that person, yet assume we know better because our reasoning is superior. I don’t have to elaborate on the myriad examples at my disposal: wars, genocides, oppressions of peoples that in so many instances began as misguided forms of protection. Just think of the protectorates the British Empire founded. (Who or what did Bechuanaland need protection from?!)

Empathy yields better results - but this is only, of course, accessible to those who have undergone similar circumstances. When my father died there was the obvious reverberation of the words “I’m so sorry” around me. While I am eternally grateful for all the support my family received, the words that will always remain with me are from my cousin, who simply said: “You don’t have to be strong. Just feel what you need to feel.” As it happened, I was numb while everybody else seemed openly grief-stricken, sobbing and keening. Everybody thought I was so “brave”. Later I convinced myself I was a cold-hearted bastard for not shedding a tear and lived most of my university years feeling like an emotional fake, not considering that grief is a shapeshifting process. It was only in therapy with a very patient psychologist that I finally “forgave” myself (there was nothing to forgive) and my cousin’s words appeared, like a prophet on a cliff with arms outstretched, giving comfort, and I remembered. I was trying to feel how others felt and hadn’t acknowledged my own emotions.

If I were to really look unflinchingly at my motives for feeling sorry for something, I would probably see a whole lot of guilt poisoning a good intention. Guilt that I am in a better position for whatever reason, for example. Let’s take the horrors that have struck Japan this week. I see the reports, watch a few YouTube clips in morbid fascination and now, as I type this feel guilty about carrying on with my daily life. Herewith a live transcript of the snowball of my Catholic guilt rolling down the hill of my brain:

…Is there anything I can do? I could perhaps join Médecins Sans Frontieres and help out. But I’m not, I am writing final exams next week. I could donate online. Have I? No. And if I did, why haven’t I done so before? What about all the local charities that could use my support closer to home…

The thoughts could (and momentarily do, sometimes) paralyse me. But there is something I can do. I can realise I’m not responsible for the Sendai disaster. I can realise that the average Japanese victim does not begrudge me being spared, living as I am on one of the one of the most geologically (if not politically) stable spots on the planet. And, maybe, without channelling geriatric Disney choruses, be more grateful for each fleeting moment of my life.

I guess it is like all the Great Clichés in life: All About Balance. And balance is effing difficult. If we run away from tragedy in fear and loathing we risk isolating ourselves; if we jump in blindfolded we can become drunk on our own emotions. Think of true victims of molestation too afraid and ashamed to seek help vs. all the false accusations generated from fake repressed memories. True survivors are astonishingly strong people – they don’t need anyone to feel sorry for them…
As D.H. Lawrence said:

I never saw a wild thing sorry for itself.