Category Archives: Epictetus said…

“Oh, What’s Occurring?”

I am indebted to BBC Radio 1’s Scott Mills, for inventing this game, based on Nessa’s catchphrase from the beloved BBC sitcom, Gavin & Stacey.

In Scott’s game, a current event or star-du-jour that ought to be known to most Britons, is formulated as a question, which is then put to a “random sample” of 10 people on “Stupid Street” [a street right outside the London radio studio] by a BBC staffer. Let’s say, for instance, “Who’s Andy Murray?” The point of the game is not to guess the truth [the right answer]; but to guess the most frequent answer given by the 10-person sample on Stupid Street: also known as popular opinion.

Ponder the epistemological implications of this innocent little game for a moment. Since the truth about such objective, scientific matters as the human role in the rapidly melting polar ice caps [or whether Lili’s crippling condition, degenerative myelopathy, can be definitively diagnosed by a DNA test] is still being debated among the researchers themselves, it is tempting to default to the “received wisdom” of vox populi. Except we try to hedge our bets by avoiding the populi on Stupid Street. Our sources [we believe & hope] are reliable. They know whereof they speak. Nar’mean?

Because I’m a curmudgeon, I enjoy trolling the pages of the Science sections of the NYTimes & WaPost, not to mention my favorite discredited source BBC online news, for their uncritical, wildly-extrapolated-beyond-the-data, later retracted, proclamations on [not to put too fine a point on it] How To Avoid Death. Regular readers of this blog will know I prefer the wisdom of Epictetus & Marcus Aurelius on this subject: accept that you are going to die of something, sometime; and live each day as if it were your last on earth. This is not to be confused with fatalism or Nihilism. Nor is it a simple-minded call to Acceptance [an overhyped new form of psychotherapy]. It’s a call to Do Your Best and nil desperandum [pace Horace].

The non-Classical, dog-Latin variant of this last phrase, “nil desperandum illegitimi” [Don’t let the bastards get you down.”] is the take home message of the “Oh, What’s Occurring” game. Are others humiliating you with their ill-informed opinions about what’s wrong with you/your dog? Do they tell you “It’s a Judgement” [handed down by their otherwise loving God]? I have several patients coping with health issues, which their “God-fearing” co-workers blithely attribute to Retribution. I urge them [my patients, not their persecutors] to play “Oh, What’s Occurring?” by assuming their insensitive critics live on Stupid Street. I suggest that on the way to work, they try to predict what prejudiced opinions these quidnuncs are likely to voice. When they guess right, they can award themselves 100 Scott Mills points. Hurrah! It is actually quite an effective cortisol-buster, to predict correctly what slings & arrows will come your way today.

This week on Lili’s walks the denizens of Stupid Street have opined that she has hip dysplasia and needs aspirin [whereas increasing numbness is actually the problem]; that I am over-exerting her [whereas the recommended treatment is a daily long walk]; and that they saw on YouTube that you can fit a paralyzed dog with wheels [oh, Zeus, give me patience]. To which I hum the theme song to “Oh, What’s Occurring?” Right out loud.

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Filed under attribution theory, comic relief, Epictetus said..., stress and cortisol

Applied Stoicism (Or, Marky Mark Aurelius Was The Man, Man!)

In casting around for ways to cope with Lili’s heartbreaking Degenerative Myelopathy, both emotionally & practically, I recently reread the Meditations of Marcus Aurelius [written ca. 170-180 AD], which are timeless, or very timely. To quote him: “There is nothing new; all things are both familiar and short-lived.”

Inasmuch as Lili’s motto, in the face of rapidly progressing back-leg numbness, ataxia (drunken-sailor gait) & frequent collapses, seems to be: “Keep Calm & Carry On,” I would say she is more Aurelian than I am, at the moment.

For instance, she is my role model for this bit of advice: “Remember, too, on every occasion that leads thee to vexation to apply this principle:  not that this is a misfortune, but to bear it nobly is good fortune.”  I texted that one to my daughter at work, who immediately “got it,” and wrote back, “So, life is how you react.”

He’s very into noticing when humiliation gets up “thy” nose, and challenging it with Cognitive Reframing concerning Locus of Control: “But death certainly, and life, honour & dishonour, pain & pleasure, all these things equally happen to good men & bad, being things which make us neither better or worse.”  You’ve been dealt a rotten hand? Who cares if you deserved it, or if it was just random bad luck? Play the hand you’re dealt, and let the Greek chorus of kibitzers tend to their knitting (to mix a metaphor): “So much more respect have we to what our neighbor shall think of us than to what we shall think of ourselves,” observed the Philosopher King. And, yes, I agree with those who quibble, “Easy for you to say, Your Majesty. Noblesse oblige, and all that; but for us hoi-poloi, in high-density living situations, ‘one man’s ceiling is another man’s floor’ [as Rhymin’ Simon says].”

Speaking of the neighbors, we have gone out of our way [and comfort zone], to explain to ours, what’s up with Lili [not contagious, not painful, “not anyone’s fault”…unless you count her breeders, but let’s not dwell on that]. They have been, without exception, sympathetic and supportive…and grateful that their dogs have been spared Lili’s fate.

But, as Marky Mark would remind us, we’re all on Lili’s journey, even if we’re not as close to the other “shore,” as she is. Therefore, he counseled, “Thou will give thyself relief, if thou doest every act of thy life as if it were thy last.” Be like Lili: “Keep calm & carry on.”

 

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Filed under Epictetus said..., gets right up my nose, locus of control

“Just Stop It!”

So said a young woman I see, to her obsessive-compulsive boyfriend, whose prolonged, ritual flicking on & off of a light switch was making them Late for a Thing they had planned to do. To her amazement & delight, he did stop it, at least long enough for them to get on with the day’s agenda. Who knew? 40 years of trying to effect changes of behavior through Socratic reasoning and other insight-oriented methods, and all along I could have done what your Dad [or at least mine] did: sonorously intone the command, “Knock it off!”

Trouble is, as parents & dog owners know, once the Commander has left premises, the proscribed behavior usually resumes.

The hard-to-extinguish behavior that I wish I could peremptorily curb [in myself & those intrusted to my care] is Black & White Thinking: the so-called Cognitive Error of perceiving everything in life as either All Good or All Bad.

Big fans of Stanford biologist Robert M. Sapolsky’s 1994 PopPsych bestseller, Why Zebras Don’t Get Ulcers, may quibble with my choice of animal metaphor, since his point is that wild beasts don’t overthink life’s adversities, therefore they produce fewer glucocorticoids, and suffer fewer stress-related illnesses. My rebuttal would be that this particular zebra is a captive of the Los Angeles Zoo [where we took his/her picture]; and if zebra-ear semiotics are anything like horses’, this one was signalling a situationally appropriate lack of joie de vivre.  “Okay, so I may be safe from drought, poachers, and my traditional predators; but, Poseidon! Is this enclosure ever bo-ring! Bring on the lions, already.”

Also, come on, how black & white can you get?

Remember the teenagers’ mantra of the 90s, “…but it’s all good”?  Usually uttered right after their disclosure of a Fairly Bad event or situation? How tempting it was to remark, “Surely, it’s not all good? Not 100% good?” Then, as now, there were also the drama queens, who at the first sign of adversity declared that a situation was “the worst!” Really? You can’t imagine an even more grim scenario? This one takes the cake?

One year when my girls were fairly young I gave up saying “Never” and “Always” for Lent: “You never clean your room!” became, “A lot of times, you don’t clean  your room.” [Far more accurate, and less humiliating for all concerned.] As gratifying as the ensuing Peace & Harmony was, it was difficult to sustain. We humans are wired to dichotomize: friend or foe? Am I the fairest of them all, or the ugliest? Do I feel “On top of the world,” or “like Hell”?

May I suggest 2 antidotes to Black & White Thinking? One, print & post this visual mnemonic of my LA zebra. Two, in response to adverse situations, try to Find the Beauty Part: the small, positive aspect that makes it “So it shouldn’t be a total loss.” This basic premise of Stoic philosophy helps counteract the “slings and arrows of outrageous fortune” [which want to get up our nose and produce rage & glucocorticoids].

At least in your head, you could try to replace the [usually inaccurate] absolutes of “This is the best” or “This is the worst,” with the words of that modern-day Stoic philosopher, Larry David, “This is pretty, pretty, pretty good.”

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“Offensive and tasteless”? Moi?

Well, I did ask. This wasn’t a random insult flung at me as I walked the streets of SoHo in the rain. If it had been, my not-your-victim-not-your-enemy rejoinder would have been: [in New York] “Yeah, that’s kinda what I was going for”; [in London, channeling my Irish grandma] “Aww, go on wit’ yez!”

As I have mentioned in earlier posts, I have been a member of The British Psychological Society since the 70s, and therefore a regular reader of their monthly periodical, The Psychologist, which makes the following blandishments to its readers: “We rely on your submissions, and in return we help you to get your message across to a large and diverse audience….The editorial team are very supportive, and it is a great way of communicating your work and opinions to other psychologists.” So, I decided to be brave & shoot an email to the Managing Editor, briefly describing my blog’s premise & purpose and embedding my new web address. That was last Monday. On the Wednesday morning, just before heading off to work, I received the following reply:

“Hi, Unfortunately our work internet categorises it as ‘offensive and tasteless’ and therefore won’t let me view it! Shame, it sounds interesting. Cheers, Jon”

To say that “I was gobsmacked,” is probably the kind of offensive & tasteless [hereinafter abbreviated to O & T] term to which the bps [their own abbreviation] objects; but I was. I deployed every amygdala-mediating technique written about in my blog, to avoid a road accident on my way to the medical center [where I work. Not the ER. Let’s not over-dramatize]. Later, I phoned my sister, the head librarian @ a Med School & hospital, to ask her what manner of firewall my blog may have hit; and she sent me an article about Filtering by Statistical Classification computer programs [FSC], which are used “to determine what content is or is not acceptable.”

Hurrah! A way out of my humiliation, at having been summarily dissed & dismissed as an O & T purveyor of filth! My wit & wisdom had simply been lost in translation, by an Artificial Intelligence language analysis program which was stymied by my [over]use of the Poetic Speech Function. All that quoting of rock lyrics and slang expressions…the literal-minded computer program just couldn’t cope. For a New York minute, I even considered changing the title of my most recent post…until I remembered the dictum of Epictetus. All we have in this life is our character. If we start selling out to avoid the censure of others, we will lose that.

So, I sent the editor another email that afternoon, explaining my “lost in translation” theory, and assuring him that, although I wrote about the dark side of human nature, my intent was pro bono publico. In the silence that has ensued, other ways of viewing “what went down” in the original email exchange have occurred to me. After watching the latest episode of Sherlock, “Scandal in Belgravia,” I realized that my high-frequency use of humiliation and, to a lesser extent, pain & suffering, might lead an FSC program to conclude that mine was an S & M website. Well, at least that removed any temptation to alter what I’ve written. Without the 4 precursors of anger, no GotWolf blog.

Then I took my own advice: “Consider the source,” and found out the following things about the Managing Editor.  First of all, and rather trivially, he was a Boy Scout. Therefore, presumably, if he had really found it a “shame” [kind of a Freudian slip, I’d say] that the “work network” wouldn’t “let” him view my blog, which he thought “sounds interesting,” he would have been resourceful enough to stroll down the road to the nearest Internet cafe and borrow a hipster’s laptop for a few minutes, to check out my website for himself.

Second, and more salient, his own Award Winning 1999 Doctoral Research is entitled “Bullies – Thugs or Thinkers?” To quote from his Abstract, “The public, the media, even psychologists: all have a tendency to stigmatise and pathologise individuals involved in threatening behavior as psychologically and socially abnormal or deficient. But is bullying a pathological behavior found only in a minority, or is it in fact a common identity choice actively chosen at certain times because it makes sense in certain social environments? Are the children involved inadequate, or could they be considered socially competent…even superior?”

I wonder if anyone from a certain Presidential campaign reads this blog?  If not, “shame.” They might find today’s post “interesting.”

 

 

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Filed under aggression happens, attribution theory, Epictetus said..., pro bono publico, semiotics

No Polar Bears’ Picnic


It’s been such a freakishly mild winter, so far, that I plumb forgot to put Lili’s snow boots on this weekend, for our walk in the Smithsonian woods. Here she is with Chris, just before [and after] flinging herself down on her stomach, to dramatize, “Large, painful snowballs have formed in the impractically luxuriant fur between my toes; and I can’t walk another step until you pull them out!” What was up her nose was unmistakably pain & suffering.

What was up my nose was the humiliation of having, through my silly mistake, inflicted needless discomfort on my trusting pet. What was up Chris’ nose was the intrusion of having to stop so often to perform the snow removal ceremony on Lili’s paws. “Tatsu” [to get her to stand up from her flung-down-dog position]; then “Su wa te” [to get her to sit down]; then “Gimme a paw” [well, you get it…].

And so as we made our halting way through our beloved woods, I chanted in my head Albert Ellis’ mantra [“This situation is not awful; it is only highly inconvenient.”], until we encountered our old nemeses: the girl with the unleashed retriever. Figuring that Lili’s limbic system was even more lit up than usual, Chris dragged her off the path into the trees, where she barked & lunged, embarrassingly but harmlessly, as the runner and her [short-haired] dog passed by, unhindered by snowballs between the toes, apparently.

But, as they say in the UK, worse was to follow! A few hundred yards later, we encountered an older woman running [sine cane]; and Lili gave her the full bark & lunge routine, just for nothing. The lady, whose limbic system was the least aroused of any of us, remarked cheerfully, “He’s lucky to be wearing a warm fur coat on a day like this!”

Later, on the ride home, Chris remarked, “I was afraid Lili would pull me off my feet back there!” [Welcome to my world, even when it’s only muddy underfoot.]

So, what’s it all about, then? Despite daily training exercises, to gain mastery over the howling wolf in Lili’s head [and, ahem, mine], we are still very much a work in progress. But wallowing in humiliation about it only adds fuel to the limbic fire [and more resulting anger]. The best thing to do is to use the cheerful lady in the woods as a role model: to Keep Calm & Carry On.

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Just in case…


The ramshackle buildings of the school my sister & I attended in the 60s, in Bushy Park, Greater London [in transit to which, we passed by Hampton Court Palace], had served as Supreme Headquarters, Allied Expeditionary Force during World War II, where Ike & the Yanks hammered Gen. Sir Frederick E. Morgan’s plan, “Operation Overlord,” into a viable strategy for the invasion of Europe. The Kindergarten classroom had been the erstwhile “Eisenhower Room.”

By March 1961, JFK had succeeded Ike as President, and inherited from him the never-viable plan, “Operation Pluto,” for a CIA-caper [the invasion of Cuba by anti-Castro counter-revolutionaries], known since its spectacular failure as “The Bay of Pigs.” Two days before the debacle, Radio Moscow, in an English language broadcast aimed at listeners in the UK, had predicted such an “adventure” [and its failure]. So too, it turns out, had the British Ambassador to the US, warning that UK intelligence sources advised that the Cuban populace were overwhelmingly pro-Castro; and they were likely to meet an intrusion onto their soil with hostility, not joy & gratitude. Nobody @ the CIA passed his message along to JFK, though.

We & our Bushy Park classmates [most of whose parents worked in or for the US military in London] were humiliated at our nation’s fiasco, and terrified by Moscow’s predicted anti-NATO ballistic retaliation [since the UK was likely to be their proxy whipping-boy]. Almost to a child, we became Nihilists, refusing to do our homework, since “What’s the point? We’re all going to be blown to smithereens by the Russians, anyway.”

So our beloved teachers, most of whom had been through the London Blitz about 20 years earlier, gathered us together and shared their experiences of Back in the Day, when actual bombs were actually falling [not just maybe, mind], every night, sometimes on friends & family, before the Yanks condescended to become Allies. “Of course we all thought about giving up,” they said. “How trivial & pointless homework seemed, when London was burning every night. But, if we hadn’t just kept on doing it, we wouldn’t have been able to go on to University and become your teachers, now would we? And where would you be then, eh?”

Concrete, but compelling role-modelling, is what they offered us. Not any of your “Not to worry. Everything is going to turn out fine.” Just the Existential question, “What if we don’t all get blown to smithereens? Maybe it would be best to have done your homework, JUST IN CASE (of survival).

So we pulled ourselves together and did our homework.

Zanzibar is sitting in a Flight Bag [also known as a Chart Case], which pilots always carry with them, even to this day, so that if their more sophisticated methods of navigation “go down,” they can still figure out where to land safely. Just in case.

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First, Face It, Head-on


By “it,” I mean your loss: of traction, of your wallet, of a Loved One, of your reason for living, whatever. Remember Driver’s Ed, especially those of you from a cold climate? The most counter-intuitive thing to learn [and to convince yourself to do, in the actual situation], is to “steer into a skid.” [Also, pre-ABS, don’t stomp on the brake pedal, just “feather” it.] Yeah, yeah. You’re less likely to “fishtail,” or even “spin right round”; but, by definition, you’re heading in the wrong direction! “Just for a moment, until you regain a bit of forward motion again,” the instructor soothes. Turns out, the same paradigm applies when you’re flying a single-engine airplane and it stalls. Intuition shrieks, “Pull up!” but your instructor says, “Point the nose down, to pick up air speed [and let Bernoulli’s principle lift you up].”

Likewise, the first [and hardest] thing to do when something bad happens to you, is to face it, already. Boy, doesn’t limbic arousal mess wi’dat? Like making the whole thing play out in slow-motion, so that you can kid yourself, “This is just a dream sequence. I’ll wake up in a minute.” I did that when my purse was stolen in London in the ’70s [even though I had lost 3 wallets to pickpockets during my years in Manhattan]. As usual, that time distortion thing has some survival value, allowing you to postpone overwhelming panic [loss of blood flow to the hippocampus] long enough to complete your Flame Out Chart protocol. What’s that? Actual pilots of actual jet planes have a laminated list of steps to take, in case of an engine flame-out [since most jets make lousy gliders & Bernoulli’s principle cannot help them overcome gravity]. It’s written down, because some panic is likely to trickle through to the pilot’s amygdala in that situation [Right Stuff notwithstanding], causing Highly Inconvenient memory loss for “What’s the first thing to do? And the second?” The Naval aviator euphemism for that is “Having a bad day.”

So, assuming you’re not in charge of a disabled aircraft–but still, not everything’s going your way–if you can get yourself to face the bad news real time [not just after the fact], your trusty hippocampus will be able to help you through it: by remembering previously learned recovery protocols, or devising a new one on the spot.

When I faced the fact that my footing was gone for good on the black ice, and I had entered the slo-mo phase of my debacle, I remembered my acting school class [which Chevy Chase must have aced] in safe-but-convincing-stage-falls: “twist to the side, knee, hip, extend arm to protect head, boom.” That’s just how it went down, on the day.

As they say about airplane flights, “Any one you can walk away from, was a good one.”

More of this next time. Meanwhile, this is West Coast Penny, visiting the East Coast for the holidays. Can you tell whether she’s looking away, or facing you, head-on?

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Filed under Epictetus said..., limbic system

Gratitude


No doubt, most gatherings of family, friends & invited strangers seated around the table on this Thanksgiving were given an opportunity to express their gratitude, either individually or collectively, either sincerely or flippantly [depending on the group demographics]. Whatever was identified as a cause for giving thanks, the very act of doing so [according to Martin Seligman and other mavens of Positive Psychology] did the “thanks-giver” good.

In fact, the more unfortunate and hard-done by an individual is feeling [like Lili on the Penalty Box Rug], the more beneficial it is, to “Accentuate the Positive” [as the lyrics of a Depression-era song advised]. Irony is almost unavoidable, and totally okay, in this exercise. Such as, in the genre of joke that ends “…unless you consider the alternative.” [Usually, being dead.] I wonder if there is, even now, a jolly japester fashioning zombie & vampire jokes in this vein…

As part of my dawn get-ready-to-face-the-day routine, while zoning out for 50 minutes of aerobic exercise [in the convenience & privacy of my basement, for which, I give thanks], my iPod playlist includes at least one tongue-in-cheek [but also sincere] “gratitude” song. For years, it has been a song off of The Holloways’ album, So This Is Great Britain? [“Generator”], the refrain of which is, “May I remind you that you don’t live in poverty? You got your youth, and you got food in your belly.” [Well, c’mon, folks, 2 out of 3 ain’t bad, nar’mean?] These days, it tends to be a song off of Paolo Nutini’s 2nd album, Sunnyside Up [“Pencil Full of Lead”], which is a Dixeland-meets-Gilbert & Sullivan-patter-song enumerating the things for which the diminutive Glaswegian son-of-a-fishmonger is grateful, featuring the chorus, “I’ve got food in my belly and a license for my telly.” I feel the BBC should be grateful that young Poalo makes the payment of Britain’s mandatory TV & radio license fee [of 139 pounds, 50 pence, Sterling] sound so fabuloso, with every refrain.

Beyond any metaphysical benefit daily gratitude bestows upon the thanks-giver, at the corporeal level, it blocks the production of cortisol and encourages the production of endorphins. I find it a helpful antidote to the 4 horsemen of what-gets-up-my-nose, on any given day. “It’s 5.15 in the bleedin’ morning, and you’re alive & able-bodied enough to be down here working up a sweat.” [There! Intrusion and pain & suffering neutralized, with one co-ordinate clause.] “While I’m busy here in “the bike room,” Lili is having a barkfest at Arnold, her neighboring German shepherd, thereby adding some joyful chaos to the morning.” [Boom! Intrusion and humiliation re-framed and diminished.]

I could go on, but you get the idea.

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About a Bird


Readers of this blog might have the impression that my mother was only a featured player in our family variety show. That flamboyant Rosie was the star. Indeed, when he was present, he was usually the Top Banana; but he would be the first to declare that my mother was the Class Act.

In telling her story, I shall try to resist the cognitive distortions of Black & White [all or nothing] and catastrophic [“This is awful!”] thinking. But it will be hard. Myrna [Deal with it. She had to.] was a precocious pianist, who began concertizing in Ohio and Washington, DC, in her early teens. She won a national piano contest, the prize for which was a scholarship to The Juilliard School of Music [whence she graduated with a Bachelor of Science (!) degree in 1943]. You are given a main mentor there, and hers was James Friskin [a Bach maven]; but Alexander Siloti [Rachmaninoff’s cousin] also taught there during her Juilliard years.

Now, Mumsley [a silly name my sister & I gave her, about the time our English cat got saddled with Ying Tong] was an elfin little creature: 5’2″ with very small hands. This is crucial to the absolutely true story I am about to relate [which I have fact-checked with my sister and the Internet]. One day in 1954, when we were living in Tarrytown, NY, our parents piled us into the wallowing Buick for a mystery tour, to a sprawling country house in a not-nearby-enough-for-me town [possibly Mt. Pleasant, near Valhalla, where Rachmaninoff is buried]. Myrna had been invited by “some Cousins of Rachmaninoff” [we figure, Siloti’s family], to “show them how she did it.” See, Rachmaninoff has been retrospectively diagnosed with Marfans. He was 6’6″ with huge paws, and wrote music for big-handed folks like himself. Now, whether they had heard her nifty 15-minute wartime radio show, or read a review of a concert she gave featuring the Russian giant, they wanted to watch her in action.

At 5 years old, and already dreading the drive home, I was morose…until the Cousins let fly the parakeets. Talk about chaos! As Myrna was playing, a bird alighted on the temple of her glasses, and stared her in the eye. Trouper that she was, she just kept on playing. “Open your mouth,” invited a Cousin. “He’ll check your teeth.” Myrna smiled, but kept her jaw clenched. When the command performance was over, a Cousin asked if we had a cat. Rosie piped up, “Yes, but we’ll take another, if you’re offering.” “Actually, we were going to offer you ‘Pretty Bird’ [the avian dentist]; but you have a cat.” “We’ll make it work!” assured Rosie; and home we drove, with a blue parakeet, who withstood the aerobatic maneuvers of Chip-Chip the tabby tom [whom you have yet to meet], and later of Alfred the dog, for 6 years, without mishap.

When Myrna was 35 [and I was 10], she got Multiple Sclerosis. The English still call the most rapidly-progressing type [which the cellist Jacqueline du Pre had] “galloping.” Mumsley had “cantering” MS. She continued to play publicly for another 10 years, although she required a wheelchair by then. She died 3 months before my first child was born, at 61 [my age now].

Because she was a Goody-Two-Shoes, teetotalling, sweet-natured person, it is tempting to reduce her life to an ironic cliche: “Virtue is its own punishment.” My sister’s & my fears for her led us to many impatient [angry] outcries of “Oh, Mums-ley!” As if we could shout her back to health. But she never lost patience with us, and not often with herself. She remained the mistress of the deadpan one-liner. The last time I saw her, my in-laws were visiting and she was listening, as always, to the classical music radio station. “Oh, I just love La Traviata!” enthused my mother-in-law. “How ’bout Il Trovatore?” rejoined Mumsley.

A Class Act.

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"Summat Chronic!"


Remember the British expression for a fleeting affliction–“summat and nowt”? Well, if that affliction lingers, it turns into “summat chronic,” an idiom which has morphed into a set of verbal twins [one good, one evil]. Thus, I could tell Lili the dog, “Girl, I luv you summat chronic!”; or most of the patrons in the vast waiting room at work [which we share with neurologists and Pain Management specialists] could say to one another [especially, if they happen to be from the UK], “Oooh! Me (insert body part) has been playin’ me up summat chronic!”

Given the connection between pain and anger, when the waiting room gets crowded, you can feel the pent-up rage rising. How tempting, to try to replicate the Keele experiment: “On the count of 3, everybody, yell out the expletive of your choice! You’ll feel better!” [Not gonna happen. Wouldn’t provide a longterm solution, anyway.]

The problem with any remedy for pain [be it a barked obscenity or a wallaby-endorsed opiate] is that–to quote a U. of Michigan med school classmate of my husband’s, Herb Malinoff, now the Maven of Pain in Ann Arbor–“When you start taking pain medications, the brain doesn’t like it. The ability to perceive pain is extremely important for survival. Pain keeps you from danger.”

There is an old cultural joke, made famous by Peter Cook and Dudley Moore in Beyond the Fringe, in a skit involving one of them trying to communicate with a baffled foreigner. “It’s no use. He doesn’t understand. You’ll have to shout.” Well, that’s the brain’s motto, too. If we don’t acknowledge the “howling wolf” of pain, or if we try to quash it with a pain-killer, the “howling wolf” is going to “throw a strop” [British for pitch a fit], and turn up the volume. “Oy! I’m talkin’ to you! ‘Danger,’ you thick-o! ‘DANGER!'” And so, says Herb, the battle of wills, between the Pain Messenger in our brain and the Pain Manager in our healthcare plan, escalates. The result is often hyperalgesia [hypersensitivity to pain].

So, waddaya gonna do? I shall humbly suggest an approach, based on Victoria Stillwell’s dog training method. When the dog first barks, she says, we should thank it for doing its job. [No doubt, she grew up with the motto, “Why keep a dog and bark, yourself?”] Not that we should literally express gratitude for the pain, mind you, not rejoice in it; but instead of asking the rhetorical, Existential question, “Why me?” [“This is awful!”], try asking the more useful question, “Why now?” [“Cuz this is highly inconvenient. I have other plans.“] Remember my “Always? Not always” prof’s suggestion, to identify the person whose head you’d like to bash in, as a headache remedy? That’s a “Why now?” problem-solving line of inquiry. The cliche, textbook reason for why your hand hurts now, is that you’ve inadvertently laid it on a hot stove. Sometimes, however, the cause and effect are not so proximate. The reason your head hurts now may have to do with what you drank last night. Or that you need an updated correction for your specs. Or that the air in your city is becoming more toxic. The less proximate the cause of your pain, the more inexorable [and hopeless] it seems. [“Note to Self: ‘Become rich enough to move away from New Delhi.'”]

Consider another well-worn motto: “What can’t be cured must be endured.” The next post will deal with non-pharmaceutical methods of coping with pain. Until then, consider Lili’s remedy for emotional stress–her favorite squeaky toy, “Duck”–the foot of whom you see here. She has more than 10 other squeaky toys; but “Duck” is her “Teddy bear.” Whenever she senses bad vibes in the household, or simply wants us all to go to bed so she can quit guarding us, she parades around with “Duck” in her mouth. No doubt, you have a “Teddy bear,” too. When our younger daughter was to have her tonsils out, we were instructed in the pre-op briefing to have her bring her favorite plush animal [“Gus” the cat], who was solemnly given his own scrub cap and who was in her arms from check-in to recovery. Henry Ford Hospital knows a thing or two about helping kids cope with pain, by first helping them cope with fear.

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