Tuesday, October 11, 2011

SIMPLE QUESTION GOES LONG WAY

A friend asked me, “Do you think herbs actually do something, or not?”

Sometimes you catch a question that hotwires your mind. I got to thinking: how do we know herbs work? Well, why shouldn’t they? Some of allopathy’s most useful medicines—morphine, aspirin, some anti-cancer drugs—derive from plants. The potency of some herbs, and maybe all, is indisputable.

Since we’re asking, how do we know if pharmaceuticals work? Well, sometimes we feel a dramatic change. Most standard medical drugs are designed to be more forceful than herbs or other alternative meds, so their effects can be readily noticeable. (Did I say “more forceful?” Frankly, we often swat flies with cannons.) Anesthetics, antibiotics and analgesics in particular make an obvious sensory splash.

But with some drugs, the question can’t be answered. Adele, a member of our cancer group, wondered if her chemo was working. “I mean, how can you tell?”

“Well, how do you feel?” someone asked her.

“Are you tired?” asked another.

We yearn for a grip on this issue, some metric handhold.

“Well, when’s your next MRI?”

“Oh yeah, my MRI’s next Thursday. That ought to show whether it’s been working.”

That’s when Alec steps in. “You mean if the tumor’s smaller, then the chemo’s working?”

“Sure.”

“And if the tumor’s bigger, it’s not working?”

“Yeah, why?”

“Well, what if the tumor’s bigger, and if it hadn’t been for the chemo, you’d be dead now? Or say the tumor’s smaller, then how do you know if the chemo did that, or if it was your diet or prayer or zest for life?”

Alec can be a bit frontal, but he’s worth listening to. “You go read studies,” he continued, “and they say it works. Well, that’s reassuring, you say. That’s all well and good, but then you think about it: wait a minute, there’s no treatment that’ll work for everyone, so what if it’s me who gets the short end? And you’re back to your original question, ‘Is it working?’ All the statistics in the world don’t matter boo to individuals, anyway. Another guy in this group years ago said, ‘The only numbers I’m interested in are a hundred and zero. Either I’m here or I’m not.’”

So how do we know if this medicine we take is doing what we want it to do? Alec’s right. In most cases, especially in Cancerland, we don’t know and probably can’t know. Probably the greatest source of anxiety among people with cancer is not-knowing. While a tumor might go unfelt, uncertainty tortures around the clock.

Uncertainty is a far more potent feature of the universe than I am. Compared to forces like that, I am, like Job, dust. The realization that I can’t rearrange reality as I’d like can be really annoying. That can invite me to ask myself why uncertainty, such a pervasive, eternal, and undeniable feature of reality, bothers me. If uncertainty is inherently universal, from quarks up, then why don’t I just learn to live comfortably with it? Would dropping my discomfort be risky or dangerous or taboo or illegal, or what?

Abraham Maslow, a founder of the humanistic psychology movement, was one of the few people to study normality. When we crave mental health, what is it, exactly, that we’re after? Of the hallmark list he developed, the one that fascinates me the most is “comfort with uncertainty.”

OK, sounds good. Where do I sign up? Sorry, this is a blog, not an ashram.
Vaya con Dios.

4 comments:

  1. If a hallmark of normalcy is "comfort with uncertainty", then the whole country is abnormal. But wait, we knew that already.

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  2. It's a dangerous time when a whole country's anxious about uncertainties. That's when people elect a "strong man," a leader who's sure of what to do. Sure, but also, history tells us, sure to be catastrophically wrong.

    I don't usually make political statements here, but the behavior of current presidential contenders suggests that's where we are now: monumentally confident empty suits. I try to keep my sense of humor by pretending I’m watching a Gilbert & Sullivan operetta.

    I guess if I were a candidate, my platform would be—following our standard conflict theme—to declare a War On Uncertainty.

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  3. I love, love this post!
    To me, the major political events in history arise from people, not the politicians--politicians react and try to capitalize on them, naturally having a self-preservation instinct like the rest of us. So that is why Occupy Wall St and Occupy Everywhere is more interesting than the presidential contenders.
    The movement has sprung up out of vast uncertainty of what, if anything, can come of it. But just like you know you have cancer, and you know you don't want cancer, you try various paths to treat it, not fully able to tell what is working.
    So, too, we know there are mammoth sums of money--trillions(like a big bad cancer tumor!)--that are sidelined right now in non-production, being hoarded by large multi-national companies that see no reason to put it into circulation by hiring workers and investing in more equipment. We know that these same corporate interests have bought both Dems and Republicans, as most of Congress is now million to billionaires--and these corporations have so much power as to have been declared people by the Supreme Court--yet, we can't seem to execute or imprison any of the corps that get all the privileges and wealth, but offer no responsibility towards hiring, or the general welfare of our communities. So Occupy Wall St is a seeming attempt to reclaim government for People, who can rightfully tilt the axis back to mortal humans, who have short lives of long uncertainty, above the almighty, deathless corporation, which exists solely to accumulate ever larger pools of money (which in turn become non-productive while people starve, or which are used to inflate speculative bubbles only the holders of mega-wealth can gamble in--leading to the crash of 1929, 2008, and the next one unimaginable if we don't get a grip on this inequality).

    Mayor Bloomberg is threatening to kick the protesters out by 7 am tomorrow (Friday the 14th Oct)--and there is massive uncertainty because the occupiers are asking supporters to come at midnight to prepare for the police, and to peacefully resist, possibly be arrested, but to return.
    These types of uncertainties are exciting, and the stuff history is made of. Both protests and cancer remind us our time is short, and we have to do what we can for each other with it. The more we help each other, the less we die when we do leave the earth. Like Troy Davis is living on at these protests, and is as alive as Joe Hill. Everyone who raises their voice for justice lives on, no matter when their brief time on earth ends. That's why we study them in history.

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  4. To promote people mattering in healthcare, maybe what we ought to try is to whole-heartedly Occupy Our Own Bodies.

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