"Mens Agitat Molem" (or Maybe, Vice Versa) [essay]

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The 19th-century psychologist William James - brother of the novelist Henry James - is remembered for having said: "If you would make a man a warrior, have him make a fist."  In other words, as James had observed, one's internal state of being ready to fight which we might expect would be expressed in the outward gesture of a clinched fist might instead be created by making the outward gesture itself first.

He might just as well have said: "If you would be happy, smile!"

This must seem ridiculous.  But in my experience, it works.

*

For years my job consisted predominantly of contentious discussions with groups of articulate and intelligent persons who were predisposed to deny and resist anything I said to them about almost any topic.   Sometimes the conversations were respectful and reasoned, but they could also be irrational though friendly, or well-argued though nasty, or both illogical and unkind. 


I held my own in these quarrelsome exchanges, if I do say so, and I even succeeded in convincing myself that others would not do as well as I often did.  Also, I got used to this kind of thing and was surprised only rarely when things went more smoothly than I'd expected.  Still, in general these were not pleasant experiences.  I didn't dread them, but I certainly did not look forward to them.

After a year or two, as I was leaving for just such a meeting I happened to pass a mirror.  Noting the grim expression on my face, I grinned satirically at myself and may even have stuck out my tongue.  But then as I turned away I noted the look of satisfaction in my expression as I proceeded onward.

Eventually, I had a mirror placed on the inside of my office's closet door, which I usually left open.  I routinely gave myself a little smile on the way out the door to any of these meetings.  Just doing that made me feel more in control of the situation, and more confident about what was to come.

I have recommended this little stratagem to others.

*

How could this work?  How could artificially manufacturing the (outward) effect bring into being the (internal) cause?

Presumably it's the old "association of ideas" once again, a common 18th-century theme.  Wanting to fight is so often accompanied by one's making a fist, or one's success in a vitriolic debate is so often accompanied by a facial expression of calm satisfaction that... well, the cause and effect become so closely associated in the mind that if one willfully initiates the effect, the cause is called up (it seems) automatically.

Does that make sense?  (If it doesn't at first, start nodding your head and then read the question again!)

*

I have this shadowy memory, from my high school days.  Mr. Anderson, the principal, was ushering me and a good friend down a deserted school hallway.  Maybe it was late in the afternoon, after drama practice, for example), or maybe it was at night for some reason?  In any case, he was going to introduce us to someone or show us something and was trying to 'make nice' as we walked to his office

I knew at the time that he felt awkward around us, and that struck me as odd (HE was the big boss, after all) and a little touching too.  Anyway, he seemed to be searching for topics of conversation, as we walked by a high school seal on the wall.  He pointed it out, especially the Latin motto around the rim.

"'Byron,'" he said.  "You're taking Latin.  What does this motto say?"

To tell the truth, I don't think anyone ever noticed there was a Latin motto on the seal.  We always talked about our school "slogan," I guess you'd call it, in English.  "Not 'Loyal Forever,' is it?" I replied.

Mr. Anderson said No.  "'Mens Agiatat Molem,'" he said (butchering the pronunciation, I seem to recall): "Mind Over Matter."

I did know the verb "agito," which means "do" or "drive" and has the English cognate "agitate."  And, now that he'd mentioned it, the Latin "mens" (as in "mental" or "non compos mentis") could mean "mind."  And after all, that's a pretty good motto for a school.  So I learned something from the principal that day.

{Note: I believe the saying is attributed to the Roman poet Vergil, whose Aeneid our class was studying at that very time.]

*

"Mind over matter" means, of course, "mind over body" too.  But it's also possible, under the right circumstances, for bodily action to direct one's mental state too.  Wonder what Mr. Anderson would say to that?

***

"Illness Recollected in Tranquility," Part the Last (IV!)

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 Note: Part I, 6/10/13; Part II, 6/11/13; Part III, 6/13/13.

IV...

There was another tube, too. 

Recognizing there was a lot of old blood in my stomach and I was not pooping it out very fast, Dr. R------- decided to put a tube down my nose into my stomach to drain the old blood out.  He must have noted the look of alarm on my face when he told me the plan because he quickly pointed out that this tube would be tiny, much smaller than the breathing tube in my lungs, and it would go down from my nose (not my mouth) so I could continue to talk and even move about pretty much as usual.

I didn’t even really feel it when the nurse stuck in this little red tube: yes, red.  I also didn't see it beforehand. 

Having this little tube installed made my nose drip clear fluid a little bit all the day and night I had it in, and the nurse assistant who took my vital signs every hour through the night must have bumped it every single time she came in (ouch!), but it really wasn’t half bad.  And the way it was doing me good was obvious. 

About 12 or 15 hours hours after it was inserted, no more blood was draining out, so Dr. R------- said to take the little tube out.

I think the sensation of its removal qualifies as an exquisite pain: not enough to make me want to cry out, but weird and most uncomfortable... qualified by the anticipation that I would in a minute be free of it altogether!  The nurse showed the tube to me after the extraction.  The part that had been inside me was about three feet long.

*

Closing day on our house had passed by this point, and since the movers had been there the day before, A----- had no natural place left to stay (some friends took her in for a day or two).  We started talking about getting me moved to a hospital in our new home city (that is, the city where our furniture would arrive any day).

The doctors all said the only way the transfer could be done was by medical jet... It took about one day to set that up.  So, on Friday of the second week, it happened.

A crew in snappy black uniforms came bustling in about noon, bundled me up, lifted me from the hospital bed onto their gurney, and whisked me away... with A----- trotting along behind.

The local ambulance took all of us to the airport; my gurney was transferred to this little private plane tricked out with medical dials and equipment of all types; I was hooked up again, and A----- was seated in front of me, although I couldn’t see her...

And we lifted off into bright sunlight at 1 p.m. Eastern time.  By 3 p.m. CST we were landing in our new home airport in the rain.  By 3:30, I was in my new hospital bed.

How slick is that!

*

I was not in Intensive Care in the new hospital, having somewhat recovered by then.  That part was good, of course; on the other hand, my range of activity was more constrained than it had been the last few days in the first hospital's Intensive Care Unit.

Since I did not have one or even two nurse assistants hustling into my room whenever I pushed the little button – instead, a disembodied voice saying, “Yes?” – I couldn’t get away from the I. V. pole at all.   

That meant my frequent strolls with walker around the halls were no more.

Also, since the assistants were not at my beck and call, I couldn't make it to the toilet anymore.  Not on my own, since I was attached to the wall for oxygen and since I was attached to the I. V. pole for medecine and nourishment, and not with help since there wasn't any.  When I mentioned this little concern, I was given a strangely shaped plastic bottle, which staff called a urinal (though it didn't look like one).

*

Since all my food was still straight from the I. V. there was no need to worry about Number Two, and after once using the plastic thing, I thought I could get along with that method...  But all the bed-rest, the lack of movement generally, and the liquid going into me through my blood veins was causing my body to swell... and not just my ankles either.  My whole legs, including my thighs, my so-called "love handles," even my bottom were collecting fluid.

When A----- pointed this out to one of my new team of doctors, Dr. W------ got staff started giving me diarhetics, more than one I think.  For the next two nights and the day between, when the disembodied voice answered my Call button, I had to report that I was worried my urinal would overflow if someone didn't come by and empty it.

(They had to record how much I had produced, too, you understand.)

*

I had a long enough connector with my oxygen that I was able to set myself up in the one chair in my new room.  I could even stand up, do half knee bends, swing my shoulders side to side...

Late in the morning of the second day, a break-through.  The doctors had been weaning me off the oxygen feed: 4 liters per minute, 2 liters per minute, finally 1 liter per minute...  Dr. W------ (I later learned) was trying to get me to see if I could get through the night without any extra oxygen at all.  Since most of my physicians - not to mention nurses - thought lack of oxygen was the cause of my panic attacks in the nights at home, I was real reluctant to try that experiment.

But when Dre. W------ said I could take off the oxygen feed whenever I wanted to in order to go to the bathroom, the real complete room, OR to take a little walk out in the hall, I jumped at the chance.  I had to ask the Voice a couple of times, but a walker did finally materialize.

I was on my own out in the hallway, but I was off!

*

Twenty-four hours later, my son-in-law was driving A----- and me to our new home, where our furniture had been somewhat oddly dispersed but it was there, safe and sound.  "Sounder" than me, of course, but we were equally "safe."

I will be grateful not to have more such vivid experiences for a while as those I had in my 18 days in the hospital!

Note: Part I, 6/10/13; Part II, 6/11/13; Part III, 6/13/13.

***

"Illness Recollected in Tranquility," Part III

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Note: Part I, 6/10/13; Part II, 6/11/13; Part IV, 6/14/13. 

III...

Other memorable moments during my recent illness had to do with the tubes going down my throat.

After three days (and two nights) immobilized, silenced, and strapped in, I was delighted to learn that I would be prepped for a visit to a procedure room downstairs where the Gastro-Enterologist would study my stomach again to see if the bleeding had stopped.  If it had, the tubes in my mouth could be removed. 

(Most people would have noted that the absence of new bleeding would mean that my life was safe, but I myself was focused on getting rid of the tubes.)

In my room, Dr. R------- installed a catheter in my groin through which he could make his investigations of my stomach, and a little while later I was whisked downstairs, anesthetized briefly, and then told when I came to that there was still a lot of old blood in the stomach but no new blood, so the tubes could indeed come out, so long as everyone else agreed – the Primary Care Physician, the Cardiologist, and the Pulmonologist.

By the time I was back in my tomb in the ICU, two of the three docs had already said thumbs up.  The Pulmonologist, Dr. E---, greeted me at the door and said, “Well, ‘Byron,’ they tell me you want those tubes taken out of your throat.”  I tried to nod vigorously and say “Uh huh!” loudly.  So he said to the assembled nurses with a flourish of his hand, “Well then, take 'em out.!

*

Before I could celebrate appropriately, however, Dr. R-------- reappeared and told me that, in order for the catheter incision to begin to heal properly, I had to remain immobile for another four hours!

In reality this was nothing compared to what I’d been going through.  After all I could talk!  I could even have a conversation.  But it was nonetheless a terrible surprise that I still couldn't move, since I’d had no inkling that I would not yet be able to sit up and maybe even stand.  Another round of rigorous self-discipline was required. 

Finally, the four hour delay was over too.

*

The nights were still a serious challenge. 

I probably slept a total on average of two and a half or three hours a night, 15 to 30 minutes at a time.  I had a Ross MacDonald mystery novel, a stack of crossword puzzles, a tablet and pen, and still the t.v.

One morning, I passed the time trying to write up an account of how I had spent the night.  My first night in the I.C.U. had been a Tuesday; the night I recounted was the following Monday... so by then I was much better off than I had been at first. 

Here’s what I wrote:

 Let’s see what I can remember [on Tuesday morning] about Monday night.  I was fully ensconced in my chair when A----- came to visit that evening.  I think that was between 7 and 8 pm.  Yes, I remember the time now.  [She probably left again about 9...]

1.    Watched Yankee game, switching once in a while to the Mets game.  Andy Petite was pitching against the Toronto Blue Jays.  The Mets were playing Philadelphia.

2.   When the Yankees fell behind 8 – 0, I gave up and started switching between the Mets and Florida, and the ESPN Monday night game between Atlanta and... oh yes, Washington.  They were both close games.

3.  Around 10 , I walked around the ICU (with my walker that had the oxygen tank on it blowing into my nose, and with one attendant pushing along my i.v. pole, since I was down to only one by then).  One full lap, and I went to the toilet (It’s good for the staff that I’ve not been pooping because I’ve had no solid food), and got set up in bed. 

4.  I started with the Mets game again and stopped switching to the other game.  After 30 minutes or so I had a good nap, lying flatter than I have been doing.  But when I woke up the Mets were just completing their half of the ninth inning.  Sure enough, the Marlins came back in their half to tie the game at 3, so I kept it playing.

 5.  I fell deeply asleep, not waking until almost 2 am (the t.v. was reporting that the Mets had lost in the bottom of the 15^th inning.)

6.  At that time, I had one of those icky episodes [of irrational, intense dread].  I wanted to just get up again.  I tried lying flatter, then less flat... No change.

So I gave in and rang for help.  The two women [assistants] were very gracious.  With their help I got up and walked a half-lap, ending up in the chair, covered all over with blankets, with the lights on low and the t.v. accessible.  I thought I was leading a charmed life when “Numb3rs” came on, about 3 a.m.

7.  I fell asleep – I can only guess for a half-hour or so – after which there was a religious info-mercial playing.  I’d thought I could just leave that channel on all night.   But with some effort I did find “That Bletchely Circle”  om PBS. I watched it all and enjoyed it a lot.

8.  About 4:45 I called the staff again, who took me for another, full-lap walk.

9.   I was ensconced in the chair about 5:15, with the bright overhead lights on, while I wrote this.

 10.  Time now, 6 a.m.  I’m going to check in on Ross MacDonald.”

Note: Part I, 6/10/13; Part II, 6/11/13; Part IV, 6/14/13. 

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Illness Recollected in Tranquility, Part II

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Note: Part I, 6/10/13; Part III, 6/13; Part IV, 6/14. 

 II...

The next morning, with me still immobilized on my back, tubes down my throat, hands bound at my sides, A----- came in early.  She herself was fighting through a tough time with a significant gastric affliction and had figured she’d be safer eating only yogurt and drinking skim milk (for two or three days). 

She said something to me, and then I couldn’t see her anymore because she sat down next to my bed.  Of course, I couldn’t respond.  I heard the nurses asking her if she was all right.  Our Primary Care Physician was there too.  I heard A-----’s voice saying she felt weak.  The doctor asked if she had been eating and drinking properly.  A----- started to answer…

But then I heard her fall to the floor.  She came to right away but was embarrassed, not only for having fainted but also for having made a big mess.  Not only was her doctor right there but there were several nurses too, who had her all sorted out in just a couple of minutes, or that’s the way it seemed to the silent witness lying motionless on the big bed.

A----- was whisked away to Emergency, and she spent the rest of the day and that night in her own hospital room upstairs.

I got the sense all this made quite a big impression on the hospital staff.  If it were possible, I think they felt even more empathy for poor ole me than they had before, and every time A------ visited from then on, she was greeted as a hero.

*

I neglected to say earlier that as our moving day approached, a rather disconcerting development had been occurring to me.  For my whole life I’ve been known for a couple of distinctive features: a strong appetite and an ability to sleep soundly.  Both of these inveterate traits were significantly disturbed in early 2013; looking back, that seems significant. 

By the end of February, I’d pretty well lost my enjoyment of eating, altogether; I ate only to be polite and because I knew I needed nourishment to stay healthy.  Also, I couldn’t sleep at night.  It got so bad I was having actual panic attacks; I knew I was all right and everything was fine, but I had a deep sense of dread and couldn’t let myself go, to be vulnerable as one is when sleeping.  It was weird, awful.

Later, in Intensive Care it didn’t matter how I felt about eating.  With my tubes, I wasn’t getting any food, only nourishment through the I. V.  But not being able to sleep and having a deep sense of dread did matter.  Big time!

At home before, when I couldn’t sleep, I just got up and did something – read, did a crossword, went to the bathroom, walked around a little, listened to classical music on the radio – and then tried to sleep again. 

In the ICR, though, I could change the t.v. channel and I could make the top of my bed go up or down… That was about it.  The rest - while I was immobilized - was rigorous self-discipline and mind games (there were seven large squares of ceiling tiles from my left to my right, each with four smaller squares inside, and there were nine large squares from in front of me to behind me).

So getting through the night was a painful struggle.  When the sunlight began to peek into the corner of my I. C. room about 5:30 a.m. I experienced such release, such a feeling of accomplishment: the night was over!  (I usually nodded off at about that time and had my best hour or so of sleep in the 24 hours beforehand… before staff came in to take my blood pressure and draw blood for the lab).

*

When I finally got my hands unbound, I could help pass the time writing.  One of the things I constructed was this:

Grandmother used to say that during a rough time, you should find one particular thing about what was going on that was good.  (Saying “It could be worse” was a cheap cop-out, by the way.)

Well , one good thing about being in the hospital is that everyone always knows what is the most appropriate topic of conversation.  You could say it was sunny or stormy, pale or dark, nice or unpleasant, dreary or invigorating… But you did know, from the get-go, what you were saying this about!

Right now, for instance, I’d say I’m fair and only partly cloudy.”

(I realized later that I’d intended to point out that this most appropriate topic of conversation in the hospital was my very favorite one for people to talk about too... that being ME!)

Note: Part I, 6/10/13; Part III, 6/13/13; Part IV, 6/14/13. 

*

Illness Recollected in Tranquility, Part I

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Note: Part II, 6/11/13; Part III, 6/13; Part IV, 6/14.

Now that I’m about 75% or so back toward normal after my recent health crisis, I realize looking back that several particularly memorable experiences stand out from the rest.

 *

The crisis began with my going to sleep (under anesthesia) for a simple outpatient procedure and waking up with two tubes down my throat, oxygen being blown up my nose, lying flat on my back of course, and finding both hands bound to the sides of my hospital bed.  Thank goodness A----- was there to explain that something had gone wrong in the “simple” procedure, and I had stopped breathing.  The tubes went down my throat into my lungs.

*

Quite a lot of solicitous people were around, looking after me when I awoke in my Intensive Care room, and the whole emergency was described to me clearly enough.  I’d already had several transfusions by then and was still receiving blood through one of my many I. V. lines.  (Altogether, I eventually got 14 pints of blood plus some plasma.)

Hovering over me during the crisis itself had been the doctor who’d done the procedure I went in for – which, I was assured, was a success – as well as my regular Cardiologist, my Physical Care Physician (I still want to say “G. P.”), my regular Pulmonologist, and a gastro-enterologist whom they’d called in when all the blood was found in my lungs.

Maybe this all sounds alarming.  What my own mind was focused on was that I could not talk, could barely make any sounds at all.  I couldn’t make gestures since my hands were tied down.  Obviously I couldn’t write.  I lay there as peacefully as I could.  Eventually it was just A----- and a nurse with me.  But I still had no way to communicate with them.  With my right hand, I was able to control the lights above the bed, the t.v. at the ceiling across the room, and the Call button if I needed something.

And this was how I remained for the better part of three days.

*

I couldn’t sleep.  I couldn’t be sedated, with the breathing problems I’d had.  I could see the clock across the room, which did seem to be moving…

On the second morning, when A----- returned, I gestured as best I could that I wanted to write something.  The very worst part of this torture was still that I could not communicate.  I thought no one realized how awful this situation was for me.  Maybe just a tiny change or two would help, at least a little; and besides, any change at all would have been something for me to think about…

A----- got the nurses to provide a marking pen and a big laminated sheet that was big enough to stretch from my one bound hand to the other, and – without being able to see what I was doing – I tried to write something like, “I am being well cared for, but this is still a pretty bad situation.  Perhaps the nurses can think of a little change here and there that might make it more comfortable, do you think?”

After I had moved my pen over the page a few seconds, A----- started trying her best to make out my words.  The process wasn’t working at all. 

After several minutes of trying and failing to be understood, I knew I had to start using large print and to simplify my message.  Simplify.  To this day, A----- remembers the one word she could make out clearly in what I wrote then: “A-g-o-n-y.”

 We abandoned the attempt for me to write.  The fifteen minutes we had spent in the effort was by far the most interesting thing I’d had to think about for the past twelve hours or so, which was some consolation.

Note: Part II, 6/11/13; Part III, 6/13; Part IV, 6/14.

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