A Medical MemoirIn ancient times, the orator Sciatica the Elder used to limp into the Roman Senate and exclaim, "Hostes alienigeni me abduxerunt." [Aliens abducted me]. He would then pound his staff sharply on the floor, after which he would add: "Ahhh, habeo dolor!" [My aching back!]
The malady to which this noble Roman gave his name was the object of much medical attention even in his time. Patients would crawl on their elbows to the temple on the Isle of Lumbago to sacrifice a chicken and consult the sages. After studying the entrails, they would suggest ice-packs, hot baths ... or both at once. The priestess of Lumbago would advise lumbar rolls and the sacrifice of another chicken.
Two thousand years later, nothing has changed. The most advanced medical advice we receive nowadays is to sleep on boards, the way Roman legionnaires did, and now we worship at the shrine of Ibuprofen, the goddess of anodyne.
My own latest episode of sciatica has been teaching me how a lab rat feels. My version of the ailment doesn't prevent me from sleeping comfortably, but then hits me after I get up and start to move around. Within moments, intense pains shoot from the lower back down one leg in pulses, gradually subsiding over an hour or two into mere nagging back ache, with only an occasional sharp twinge.
After the first couple of days of this aversive conditioning, I lie in bed each morning, dreading the punishment that will come as soon as I get out of bed. This must be exactly how the lab rat feels before the electric shock is applied. My conditioned resistance to getting out of bed soon becomes so powerful that it amounts to terror. I would certainly be capable of never getting up at all, in order to avoid the punishment except one has to pee. There it is: a command of nature in conflict with the aversive conditioning. If this conflict continued for long, I might become interesting material for the clinical psychologist.
Aren't lab rats reduced to blubbering neurotics by unpredictable punishment? That happens too. After things have settled down to low-level ache, there are still unpredictable twinges; you never know when to expect them, nor what motions to avoid in order to prevent them. After a few days of this, I become glum, irritable, my little nose twitches, and I experience an urge to stockpile food pellets or run on my little wheel all day.
I am, in short, getting in touch with my inner lab rat. And also the inner automaton.
I admit I am a groaner. I treat each spike of pain shooting down my leg with a grunt, and accompany the lower back part of the experience with groans, in the key of B-flat. I don't know why I do this, it doesn't help at all. An invisible hand presses keys somewhere in my control board, and the sounds come out of me. It is machine-like, utterly automatic, analogous to the philosopher Descartes' conception of the animal as an automaton. But, Descartes, who must have had a fortunate life experience, missed the discovery that he himself was an automaton too: I groan, therefore I am.
This exploration of the mind/body problem makes me think about my friend Ranjit's adventures in mental hospitals. Ranjit is a gentle, deeply ineffectual soul who has been hovering on the fringe of American life for more than 30 years since he emigrated here after completing college in Mother India. His guiding proverb of "slowly and slowly" does not suit him for high finance or driving a taxicab, but he gets along well enough through intermittent work in teaching, waiting tables, and clerking.
In between stints of employment, he maintains a regular schedule of nervous breakdowns. Each time one occurs, he retires to the psychiatric ward of whatever hospital is handy, and after a few days he always emerges refreshed, ready once again to resume life in the slow lane. The latest episode occurred this past Summer.
The breakdown revolved around sleep and food. Ranjit began to worry whether he was getting adequate sleep, and in fact he worried so much about this each night that he couldn't fall asleep. Then he began to worry about digesting his food. As a consequence of this anxiety, one type of food after another gave him acid nervous stomach, until he couldn't manage anything, not even rice, not even tea. Then he worried about what would become of him, and what this mysterious digestive malady might be.
I did my best to reassure him, explaining that his symptoms resembled those of leprosy, and he would certainly feel better after his nose fell off. He was not reassured, and eventually threatened to commit suicide by swallowing an entire bottle of Tums. A few of us realized that he was again ready for a period of psychiatric confinement, and we drove him down to a large public hospital with a psych ward popularly known as the Flight Deck. Ranjit was admitted to treatment, but the Flight Deck, evidently a popular locale, was full up. So they assigned him instead to the mental ward of St. Dismas Hospital, an old institution once run by a religious order, the Sisters of Flagellation.
St. Dismas is a huge, forbidding brick fortress, a square block in size, located in a slummy part of town. It looks like a 19th century prison --- a haunted 19th century prison. I lived near it at one time, and used to fancy that I heard cries, groans, and the rattling of chains emanating from behind its walls late at night.
I picture the inside of the place as a labyrinth of endless corridors, something like the Overlook Hotel in the movie "The Shining", but a little less cozy. There would be spectral attendants in white coats and wire-rimmed spectacles, and ancient electrotherapy machines with frayed connections that make sparks. The laboratories are no doubt filled with unrecognizable things in Bell jars, sharp instruments, and skeletons. Just the thing for a case of nerves.
But, after five days in the place, Ranjit emerged completely restored: calm, smiling, urbane, self-possessed, and eating every sort of food under the sun from curry to pizza. What miracle of modern medicine had produced this spectacular cure? Well, maybe they are more up-to-date behind the walls of the old hospital than it looks. Maybe the DNA revolution has arrived, and perhaps they treated him with genetically modified hospital cafeteria food.
Or maybe all it took was some Prozac or Paxil or another of that army of SSRIs which they now prescribe to anyone who so much as telephones the hospital or passes by on the street. Psychopharmacology has arrived at a new form of Descartes' postulate: I take a pill, therefore I am.
Whatever it was, it worked for Ranjit. Come to think of it, I wonder what the medical wizards at St. Dismas could do for my lumbago. Could they perhaps alter my DNA, or adjust my neurotransmitters? One day, as soon as my back feels better, I think I will crawl down there on my elbows, sacrifice a chicken, and ask for the doctor.--- Dr. Phage