Sunday, November 23, 2008

Subjectivity, Science and the Off-Ramp

Blimey. That mild expletive apart, posting is proving difficult as I have the worst case of jet lag ever and one of the most persistent chest infections - both signs, I suspect, that life's off-ramp is somewhere round the next bend. My chest has never been much good - as a chest at least. Every winter for the last five years or so I have caught a cold that turns into a sinus infection followed immediately by a chest infection. The solution is two courses of antibiotics accompanied by inhalations of Seretide, a steroid in powder form which I suck in from a small hole in the side of a purple plastic flying saucer. Bones increased my Seretide dose this time round - yep, that's the off-ramp - and, returning for my second lot of antiobiotics, I remarked that this higher dose gave me a slight steroid rush. This rush will be familiar to anybody who has been on high doses of oral steroids - it's pleasant in that it gives you energy but unpleasant in that it destroys your concentration. Bones responded to my rush report by saying, 'Hmmmm, it's supposed to have only a local effect.' Translation: 'You're imagining the rush.' I found this troubling. Obviously, at one level, I simply can't be imagining the rush. Only I have access to this rush and, if I feel it, then it's happening. But that's precisely the kind of epistemology that screws up doctors and drugs companies. If they have to acknowledge the legitimacy of every reported side effect, then the warnings on American TV drug ads will wipe out the schedules, every time you turn on the TV on the Holiday Inn Express you'll be told that Seretide can give you a mild rush and the little slips of paper that come with your drugs will be replaced by telephone directories. They will say, of course, that I am not to be believed as Seretide's effect is purely local - probably an aspect of molecular size - but this is unpersuasive as we now know that drugs have wildly different effects on people, probably because of subtle genetic variations called riflips. This is all further confused by the placebo effect. It's worked on me - since encountering Bones's scepticism, I haven't been getting the rush. I might up the dose further just to convince myself a non-local effect is possible, so if the next thing you read is my obit, you'll know what's happened. This liminal land between subjectivity and science is, as ever, a fun and risky place to be.

16 comments:

  1. Try to think of it, Bryan, as more of a gradual downward spiral, with nine concentric circles, than an off-ramp. This will help.

    ReplyDelete
  2. Try lemon with a tablespoon of honey in a pint of boiling water. And if you can stand it, a twist or two of pepper. it is a sort of homemade lucozade. Or a good shot of vodka/single malt -Irish is best- with the same twist or two of pepper. Either should, one way or another, put some pep in your step.

    ReplyDelete
  3. The reason you're not getting a rush anymore is because you're building up a tolerance. I'm also fairly sure steroids are used recreationally as a club drug, though I could be wrong.

    ReplyDelete
  4. Whither the superman diet that makes you immune to all ills?

    As a youth I had a fairly intense relationship with the asthma drug Ventolin. I even wrote a poem in praise of it, luckily now long lost. Lovely name, though, Ventolin. Sounds like a musical instrument from Star Wars or something.

    ReplyDelete
  5. i have bad asthma (hospitalised several times, nearly died at least twice) and also take a lot of this stuff. It can give you a heady feeling of incorporeality and unbalanced energy.

    If you have asthma-like symptoms, two things i've found help:

    1. Prepare to die. Meditate and write a Zen death poem. i did this in 2005 or so and my lungs cleared immediately. i suspect this is one of those one-time only cures, i never tried it again (how many death poems can a man write?). Here's my death poem, as i wrote this the rain had stopped falling outside:

    the rain has stopped falling
    puddles hold a spent sky
    a broken bird takes flight.

    2. Drink strong coffee. i'd heard Proust sometimes used this so gave it a shot as my Ventolin/Serevent/Seretide wasn't working and i could feel my brain functions shutting down. This worked about 3 times then it's as if my asthma 'defended' itself against the cure, and it wouldn't work the next time.

    You should try chi kung to build up energy and immunity, very simple, takes about 15 mins a day. It's hard to f*ck up chi kung so probably any half-reputable Tai Chi class could teach it, even if their actual Tai Chi is a joke. Alternatively, i could email you how to do it (it is very simple), if you're curious - it doesn't incidentally seem to matter if you 'believe' in it or not - i did it with no expectations, even a slight scepticism, and found it almost immediately cured my insomnia. It also tends to massively increase libido, not sure if this is a good thing for a man who routinely meets women like Kylie & Monica Bellucci, it's like being 15 again when you see a pretty girl walk by.

    i hope you don't die though obviously you eventually will.

    ReplyDelete
  6. Elberry, I really like your poem. Did the broken bird fly in circles?

    ReplyDelete
  7. Since i didn't die this time, i guess the broken bird didn't take flight, Susan! - though, funnily enough, i tend to return to places i've been in before i was born in this life, so i guess you could say i spend a lot of time circling around old roosts.

    ReplyDelete
  8. My body is a temple to the medical professions mistakes. I am lacking appendix, removed despite the fact that I did not have appendicitis.
    I still have a wotsit in the throat due to a botched removal job thirty years ago, "its in among the telephone wires" he said. Telephone wires, what did he think I was, a f---ing PBX exchange?.
    The face is, sort of not very well refurbished, after a collision with an dead Austrian on his way down to the bottom of the Bonatti Pillar, at least he was dead at the bottom, I think the plastic surgeons eyesight needed more attention than my face.
    I paid a private physio a kings ransom after the NHS prune told me I would never climb again, this led to another fifteen years of active mountaineering. A fall down a crevasse plus thirteen kilometer walk out had pissed off the right knee a bit.

    So Bryan, air travel = germs, medical operatives = crap advice,
    buy a copy of Tony Smiths Family Health and smile. And travel by bike.

    Remember everyone, The Plan.

    ReplyDelete
  9. Er, Malty, I think we need to talk

    ReplyDelete
  10. Those are pretty amazing stories, Malty. The awful prognostications of these NHS prunes only strengthens the suspicion that a lot of doctors are not merely mad but actively sadistic. In recent times I've been told that in future I can expect to suffer from "arthritis, possibly agonizing". I suggested the doctor look at my notes as he would find this old news: I already had arthritis. Another one told me that I had a very high chance of being in a wheelchair in ten years' time. I may well be, but not for the reason she supposed. In fact I binned her "advice" there and then and have never looked back. Far more active now that I was when I saw her.

    Sorry to hear of your own tribulations, Bryan. Get well soon and enjoy the buzz while it lasts. The placebo effect strikes me as hugely important in getting well and I don't think the scientists have yet worked it all out. Just be glad it exists. Imagine if doctors really were our last and only hope.

    Everyone ends up with something. All you have to do is hang around on the planet for long enough.

    ReplyDelete
  11. Only I have access to this rush and, if I feel it, then it's happening.

    Well, that's a poor argument.

    ReplyDelete
  12. Brit, Aphex twins have also written a song about ventolin:

    http://en.wikipedia.org/wiki/Ventolin_(song)

    ReplyDelete
  13. Rather pleasingly, i just had a mild asthma attack and was panting like a rapist on the walk to the bus stop.

    ReplyDelete
  14. 'Song' isn't the word, Anonymous, it's an unholy racket.

    He's mostly unlistenable, but I advise everyone to buy Aphex Twin's 'Selected Ambient Works Vol 1'. It is an extraordinary album, the pinnacle of electronica.

    ReplyDelete
  15. Elberry - that death poem is indeed very fine.
    Believe it or not, I also practise a loose version of chi qung every morning and find it makes me feel a whole heap better than I would otherwise. Hand't noticed the libido effect though - which is probably just as well...

    ReplyDelete
  16. Malty, good lord! Your wife must have spent most of your marriage terrified at what you would do next. What happened to your face?

    Let me suggest, again, a fine book by Sebastian Faulks: "The Fatal Englishman." Three biographies of English guys with a death wish, or so it seemed. Malty, you might like the one about the WW I flying ace. He lost his face after one mission -- he crashed, his face was burned off (he had been an exceptionally handsome man). Faulks then details the very interesting beginnings of plastic surgery: To treat disfigured Great War soldiers.

    It's a great book, dudes. Faulks' best, of the ones I've read. And short!

    ReplyDelete