An Uninvited Visitor
I’m writing here about a visitor I’ve never welcomed and am quite sure I never will in the future.
I said “last” in the title of this brief reflection most particularly because I wanted to refer to the most recent visit paid to me, but I am perhaps also secretly hopeful that this will be the last of all; that my unwelcome guest will return no more. We all wish to have considerable control over those who come and go in our lives. We suppose we can wisely influence with whom we spend our time and where we expend our life energy, but we exert less dominion than we suppose, and so much less than we wish for.
As much as I might feel captured by the Invictus dream of being a ruthless and courageous creator of my own destiny, or moved by Melville’s prose poem in celebration of the helmsman, Bulkington, who sailed into the teeth of the storm rather than dive towards the false comfort of the port. As much as these vaunting images inspire me, they also feel not quite true to the living of an ordinary life. The poet Henley, in his famous poem, Invictus, which so inspired Nelson Mandela during his long imprisonment, says “in the fell clutch of circumstance I have not winced nor cried aloud….I am the master of my fate: I am the captain of my soul.” How stirring! How seductive! And how unlikely. Bulkington? Well, I could never quite manage to figure him out. Was he a hero, boldly steering the ship out into the sea and away from the rocks at the shore as Ismael seems to believe? Or was he a madman like his captain, unable to tolerate life on land, unable to manage life amongst people? One commentator compared him to the Greek hero, Hercules. Like many Greek heroes, Hercules is the child of a god and a human and suffers the tragic problem of these unions, a problem the Greeks were endlessly fascinated by: hubris. Hubris referred the folly of a man seeking to be a god, to be freed of the bondage of human frailty. Only trouble arose from this aspiration. So I can hear martial music and feel like I might fly after all, but I think of Icaras and hesitate. So I would like to thrash my visitor, to crush it with my indomitable force of will, but I find that ambition thwarted.
My visitor last week was pain. I’ve had his company before. At the age of 12, I developed acute appendicitis and can remember the knife swiveling in my bowel. That pain was deep inside of me and felt deeply disquieting. There was no agent to attack or explanation with which to reassure myself. Not very long ago, I slammed a mental gate on a finger (one of my own) and felt a couple of hours of agony, relieved considerably by having the blood accumulating beneath the nail drained away, and relieved much more by the certainty that this was transient. Several kidney stones have snaked their way down one of my internal tubes, like claws tearing away at me from the inside. I remember being drenched with sweat, and retching into a waste-basket. But I knew this, too, would pass and bearing almost anything is made more manageable with some assurance that it is only a temporary imposition.
My latest pain arrived stealthily, requiring several days to progress from a vague discomfort behind the left scapula to a sharp and unpredictable stabbing which seemed to arise without any reason. It felt as though some new posture would surely alleviate the attack, but none did. Then it would quiet down and tease me with a respite, only to leap without warning and stab me once more. Sleep was an old friend, long gone, because no position would afford relief, and any temporary lapse into a doze was sure to be suddenly interrupted with another pick to the back. I attended every class in medical school. I paid attention and learned most of what was required. I should know what this was. I did. It was a pulled muscle, the result of the fall I had had skiing several weeks before. But why then was it only now announcing itself? That didn’t really seem likely. What then? Nerves were the other likely cause. A decade before, my wife had had a brachial neuritis which took months to resolve. She had attended medical school as well and had a diagnostic knack which amazed everyone who knew of it. During my first and most mysterious assault by a kidney stone which had gotten me out of my bed in the middle of the night, but no further than to writhe on the bathroom floor, she stood over me having just been awakened, and said “We’re going to the emergency room now! You’ve got a kidney stone!” Her exam had been conducted while staring at me for 20 seconds or so. She was like a human MRI machine, without so much noise. She was right, of course. So her hunch that I also might very likely have a neuritis seemed unwise to dismiss. But it is my unfortunate nature to want to dismiss nearly everything afflicting me with the odd conviction that time is the very best doctor. After several days of trying to minimize the pain to myself, and, especially, of not sleeping much, my sophomoric optimism was tattered.
I would have to sail towards, if not precisely into, this pain. I spoke with my dear old friend and internist with whom I had shared a year of medical training, had a cursory exam from him in the gym (with a tacit understanding from us each that this meant little), scheduled an MRI, and a day later began several medications which seemed plausible ways to reduce the pain. That pain, which I had now lived with for about five days, had rapidly assumed a central position in my daily life, as medical infirmity always does. I was able to work somehow, and was relieved by work’s requirement that I attend to something other than the preoccupying and regular stabs to my back. Remarkably, sometimes within a moment or two following the departure of a patient from my office, I would again be completely be reabsorbed by my discomfort. Was it unreal then? Did it show up only during the vacuums? I could not really believe it, but some self-doubt loitered in my mind.
Fortunately, the steroids worked their magic overnight after the very first dose, reducing the intensity from, say 75 (of 100), to perhaps 20. It has continued now to linger around 20; disturbing and distracting, but hardly impossible to live with. How astonishing it was to have this guest decamp! Hopefulness and optimism returned like a tide kept at a distance for the six previous days. Suddenly I was again imagining the projects I would attend to, the work that would suddenly be manageable. Like my excitement on the final day of school when I raced ecstatically to summer freedom which only days later had been weathered to summer boredom, these spasms of optimism quieted while I regressed to the mean. A shadow remains. While the severe pain has gone, it has left its little ghost behind like the bill-collector’s calling card. I glance at it as though it were the undertaker’s card, a little reminder of my mortality and frailty. I know now that several cervical disks bulge a bit, and that this pain could prove difficult to eliminate. I might improve, remain here, or deteriorate. This visit cannot be the last. Keep breathing. Keep living.
