Masks

I've made this plan before: it is redrafted every time my life falls out of balance and I forget to be happy with my station. I've neglected my spirit and forgotten my way.

Medical school is stressful and draining. More than the constant onslaught of information you must struggle to absorb, you must make peace with the mortality of which your learning material is entirely made from. I'm talking about case studies to actually gross pathology specimens from long dead individuals.

During these periods of anxiety I am exceptionally sensitive the morality presented to me. I do an imagining module in where a CAT scan of a 32 year old man's abdomen showing cancer of the head of the pancreas that has metastasize to the liver. This man is as good as dead at the time of seeing this. The odds of this happening to any given person in the United States escapes me, or I've ignored it, probably cause I just want to obsess on the horrific nature of the situation.

I wonder if medical school is the right endeavor for someone so sensitive. Though, I think it is the only way for me to conquer the disjointedness I feel when it comes to death. People, my fellow people, can live happy productive lives in harmony with the world around them. I hope that whatever I do in medicine, I can make that a reality for those I care for. Though, because of my research track, my affect on patients maybe only through research.

There have been many small disillusionment since I've started med-school, and I've become negative. I am, unfortunately and all too often, of the glass-half-empty school. Having divulge that, I feel like every time I turn around a staple of medical treatment is under fire for some unforeseen morbidity. That and the many aliments that we can offer only palliative care.

In truth though, we have entered a golden age of medicine since the advent of antibodics. In this contury commuicable diseases have all but disappeared, thanks to sanitation and antibodics. We still struggle with some viruses, and they can be particularly frightening because or the ripidity at which they can change and infect (e.g. bird flu).

The good news is ( and I have to tell this to myself often) in this country you can eat whole local foods (unprocessed) and exercise, not smoke and drink too much, not have sex with hundreds of people, and you'll practically live forever. There are though outliers that scare me, and everyone with a nervous disposition.

So here I am 3 weeks into another self corrective cycle of anxiety and reflection. Once I rule out those pathologies which would cause me to die suddenly, I need to search my soul for the reasons why I wake in the middle of the night feeling like I do. I need to find the root of this anxiety. It is much like unmasking the ghost in Scooby-Doo, but often the ghost has many maskes. Each one can be a frightening as the one covering it, and, if I don't die of fright, I remove the next one. It will happen that I give up and turn away, as I have I the past. The ghost will wheel me 'round in time and I will resume removing the masks, always hoping I will uncover the face of my fear.

If I troll the deepest part of my heart, fear comes to death. I do not fear suffering or pain. I do fear a loss of control. I fear the unknown. No matter how much time I spent ruminating on this subject, I will never come up with an answer. No one in all of human history has, though there have been many claims. All I can do is take cues from the universe around me. Perhaps its vastness, its forces and cycles, its manifold variety holds some clues to what will become of us.

These past days

It has been an intense week and a few days. I guess from the outside it would appear that I am losing it.

A few months ago I started to become nervous while it worked out at the gym. All of a sudden, my heart rate and forcefulness of its contraction while exercising became very noticeable (only 15 minutes in to a workout usually). Having the type of impressionable and creative mind I have, I immediate developed many potentially fatal explanations for these phenomenon. The only way I've adapted to deal with such potential hazards of life is to worry the shit out of them. As you can imagine, nervousness turns any cardiac abnormality into an amplified abnormality. The other permutation is that nervousness turns any regulate cardiac response into a completely inappropriate cardiac response. Oh dear.

I like to think in terms of hunter/gather a lot. That is, if I were a hunter/gather would I have this problem. In short, no. I wouldn't be alive, no doubt. Since even the most mild of myopias prevent you from hunting effectively, I'd have starved to death sometime around eighteen, which is only five years from the average life expectancy anyhow.

So did ancient man worry about random heart defects, sudden vascular events and other abrupt and fatal maladies? No. They didn't know about them. And even if they did, who'd have time to obsess over these unworthy thoughts?

One does not have to go so far back to find people who would find this worrying thoughts I have a complete waste of time. I suspect in this world only a fraction of a fraction of people ever entertain a thought about dying when they are completely healthy and safe (as I am). It is embarrassing to admit that I have worked myself up to the point where this interferes with my life.

Indeed it has. In mid-February, I began to seek help for the exercise anxiety by self-medicating with an SSRI I used to take, but discontinued in January due to weight gain. Four days into starting it I had a severe night-time anxiety attack during which I drove to the hosiptal. I woke Tara out of a sound sleep and she was understanably terrified. It seemed purdent to discontinue that drug. I continued to have my exercise anxiety, so I went to the health clinic for a consult. I was seen by a PA who I recognized from a previous visit years ago went Samatha, my college girlfriend, requested I get multiple STD tests before embarking on a sexual relationship.

He is an excellent care provider, this PA. He prescribed me Lexapro, which I'd taken before and told me to drop about fifteen pounds. After that visit, things became worse. Everytime I attempted activity I found myself concentrating on my apparently overworking heart. I stopped the gym altogether. Out on a bike ride I noticed my heart rate was unusually high for the amount of activity I did. Then it was happening as I was climbing stairs. I was becoming both scared and frustrated.

I have a problem, however, that prevents me from distinushing real from mind-made. I've found over the years of dealing with this anxiety disorder that my mind can make just about any symptom appear short of coughing up blood...and actually dying. I feel that I committed to something with out ever knowing it, like a pact with the medical gods--the mean and indifferent medical gods.

"Take this head. You'll know all symptoms to all rare and fatal diseases", say the gods to me at the primorital lowering of my skull onto my body.

"Sure!", I say, "That sounds useful!"

"Oh yeah, hey, there is kind of a catch", on of the gods say to me over its immoral togaed shoulder. "You'll think you have every last one of them and it will eat you up."

"Yeah? Thanks. Can I have some rational thought to deal with that?"

"No. We gave that to that calm fellow over there."

And so, every so often, I cry wolf. I've never visited the ED for any phantasma affliction, that is until last Friday. This was a huge blow for me. I thought that whatever my anxiety through at me, I would not make it so real as to visit the ED and expect them to save my life. In other words, I made it real enough to myself that it became real. That has never happened.

There is an addition diminsion to this disorder of my neural wirings. I have cried wolf long ago when I was a child with anxiety and I feel I will not act quickly enough, or at all, if something is actually wrong with me. That is the price I pay, I suppose. Worrying is as addictive as heroine, and I can't seem to kick it.

As I deepen my medical knowledge, I pray that some power helps me to become rational. I hope that I can except with peace the truths of this life: that I will die, that ones I love will die and that it is not a source of worriment or hand-ringing. It is the way life has cycled on this earth for billions of years. I would think it would feel as natural as living.

My love

Before I retire, though I might be up to write more if my condition drops by, I want to write about my love.

There has been a huge amount of my life left out of this already chronologically patchy narrative. I finished the lifecyle in 07, and was in the finest shape of my life. I spent the remainer of '07 out in SF and part of '08. During fall of '07 I finally convinced a woman that I was worth knowing and maybe even having a relationship with.

This woman, Tara Bates, is by far the most lovely girl I've ever known. I'm not sure what happened in my life that has led to such beautiful experiences, certain something super-natural. Stoppop

Why are you doing this?

There is a reoccurring theme of my life is a violent return to balance from imbalance. Just like a collapse of a society or a forest fire, an unsettled, anxious wave pulses through my veins during the times when I have lost my way and I must atone.

I've always been an anxious person. From as early as I can remember, I felt like the world was a chaotic and random place. And it appears to be, at first glance. So, I feared nature because I was isolated by society and society because it lacked nature. I fear the human condition because it is frail and fragile. I seems strange to fear the workings of your own body will fail you. No one ever promised me complete control. Yet, I feel entitled to it.

This is one of those times when I am feeling those pulses of anxiety. In the past these episodes corresponded with a changes in my life: my parent's divorce, my return to Maine from a brief stay in Maryland, my mother's move to Vermont for medical school, the end of high school, the end of college.

My first clear anxiety episode was when I was in fourth grade. At the time we were living in Greene, Maine. It is a solid half-hour from town. I remember watching Loony Toons one night when my parents were out. I had a cold at the time; I don't even need to remember it specifically. Odds dictation that, if you were a kid in Maine in the winter, you had a cold. Anyhow, all of a sudden I couldn't breath. I remember gasping and gasping, taking in huge gulps of air. My hands and feet began to tingle. There was no doubt in my mind that I was going to die. I don't know if I called the neighbors or my sister, but Kathy Pepin came to my rescue. Upon arriving she immediately ran the shower as hot as it would go, put a towel over my head and told me to breath the steam as deeply as I could. I was a miricle. I got my first entoxicating dose of the afterglow of anxiety.

This afterglow is as addictive as any other drug. Not to mention the sick pleasure one gets from obscessing contastly about these issues.

I've not slept through in going on 8 nights. I hope tonight I can.