In Your Dreams. Or Just Prior To Them.

I have mentioned before that I am an archaeology buff (and that theme will be returning in a few weeks, methinks).  This led to me reading Inside the Neolithic Mind by David Lewis-Williams and David Pearce.

It's an interesting book but right at the edge of my brain's ability to cope.  I found some of their arguments tautological and some others about altered states of consciousness  too abstract to be convincing.  But I especially enjoyed their examination of the mound tombs of Ireland, especially since I have visited Newgrange, which is one of them.

Here is an example of an attempt to think about how neolithic (late stone age, roughly 12,000 to 6,000 years ago) people used to think.  Those mounds are decorated with abstract designs of various kinds.  Do those designs  have any meaning, or are they effectively doodles?  Is there anyway to tell?

Someone surveyed those designs and found out there is a pattern to them.   For example, spirals - like the ones I photographed at Newgrange - always appear at the entrance way to the tombs, not deeper inside. Different designs show up in the burial chambers, and so on.

So they aren't random.  Those pictures meant something to their creators; we just don't have a clue as to what.

 But what fascinated me most was a different topic the two Davids mentioned: hypnagogia.  Ever hear of it?  You may very well have experienced it, as most people have.

Little Bear

Hypnagogia is the period just before you fall asleep and especially the visions or other sensations you experience in that half-awake state.  The Davids think that the most common visions are hard-wired in our brains and tell us something about how our Neolithic ancestors would have interpreted their world.

I can clearly remember the first hypnagogic hallucination I experienced (or was aware of).  I was in my thirties and one night I saw a bear, in the style of Maurice Sendak's Little Bear books, standing on his hind feet, wearing a police hat, and walking under a stone arch.  It was a non-moving two dimensional picture and it was so convincing I thought I must be remembering it from a Sendak drawing, but I have never found such a picture.  Attached you will find the DALL-E AI program's attempt to capture the image.  It isn't very close.

Once I learned about  hypnagogia  my post-Neolithic brain immediately asked: Can I get a crime story out of this?

I did.  It's about a fancy dinner party where the host starts explaining the concept to his guests, one of whom seems a little too interested... "Hypnagogia" appears in the May issue of Mystery Magazine.

One more thing: R.T. Lawton and I usually swap stories for critique before sending them to editors.  In this case he told me he liked the end of the story  but the beginning was boring.

I changed the opening sentence and I think it made a difference.  Here is the old version:

"I beg you,” Karla called from the kitchen. “Do NOT tell them about your dreams.”

And here is the new, Lawton-inspired version:

"I warn you,” Karla called from the kitchen. “Do NOT tell them about your dreams or I may get violent.”

Just a tad of suspense to begin with.  

Until next time, sweet dreams.   

Metaphors and Morality Plays

The sun was warm but the wind was chill.
You know how it is with an April day
When the sun is out and the wind is still,
You’re one month on in the middle of May.
But if you so much as dare to speak,
A cloud comes over the sunlit arch,
A wind comes off a frozen peak,
And you’re two months back in the middle of March.
    - Robert Frost, "Two Tramps in Mud Time"


We're back in the middle of February here, folks.  With some regularity.  Now I don't mind a snow day every once in a while.  I think of all the things I can get done, like read a good book, finish cleaning out that closet, or (gasp!) writing.  But of course, too often, what happens is that I end up, hours later, looking up from an internet reading binge that is only occasionally informative, as in,
Do you want to see the oldest tree in the world?
Answer:  hell yes!

6,000 year old Senegal baobab tree.

6,000 years old.  Think about that.  That means that huge tree was a little sprout/twig back in 4,000 BCE.  That's a long way back.  It's right on the border between the Neolithic (New Stone Age) and the Bronze Age; humans have learned to cast lead, smelt tin, copper, and are just starting to smelt bronze.  There's agriculture in China, Egypt and Mesopotamia, as well as animal husbandry, tamed dogs and cats, pottery, combs, beads, and lots of clothing.  But there's no writing, not yet, so we don't know how all of this happened.  We can only imagine.

(Fun note:  6,000 years ago, there are still mammoths on Saint Paul Island, Alaska, and Wrangel Island, Russia!)

Opium fields

The other thing that's already been developed is alcohol, both beer and wine, and perhaps strong liquor, in China, Egypt, Mesopotamia, Georgia, Sicily, etc.  Traces left of fermentation have been dated back beyond 8,000 years ago, which proves what I used to tell my history classes:  no society has ever been found that was able to live drug free.  They always had something.  

Alcohol, marijuana, mushrooms, and opium derivatives are universal and thousands of years older than any writing.  Which makes sense, because living in a physical body is going to get painful sooner or later.  Think of the pre-industrial world:  tens of thousands of years of hard work done without benefit of machines, accidents, wars, beatings, old age, botched surgeries, unsuccessful surgeries, cancer, medieval dentistry, ancient trepanning, arthritis, osteoporosis, rotten teeth, and all the other wear and tear of daily life.

As Dr. Samuel Johnson said in the 18th century, about alcohol:  "He who makes a beast of himself gets rid of the pain of being a man."

I bring all this up because Buzzfeed posted a great article April 3, which I read while watching the snow whirling past my window, called "The Opioid Crisis Isn't a Metaphor".  Quite simply, it points out that - contrary to innumerable modern op-eds - people aren't drowning in opioid addiction because post-modern life in America is hell on earth.  People have been drowning in addiction and alcoholism since the Epic of Gilgamesh.  Life, any time, anywhere, will sooner or later get you taking serious medication. 

Oxycontin 

And - as the article says - that's why people generally start taking opioids:  they're in pain.  And when it comes to severe, teeth clenching pain, aspirin, Advil, or Tylenol just don't cut it.  For that, the best thing is still opioids, the derivatives of that ancient poppy plant, cultivated for multiple thousands of years, but now processed to a fare-thee-well:  codeine, heroin, morphine, all those oxys, and the latest scourge, fentanyl, which would drop an elephant in its tracks.

But even then, people in pain really do not "addict" that easily.  Unless they're widely available, as in West Virginia, where out-of-state drug companies shipped nearly 21 million opioid painkillers to two pharmacies in Williamson, WV, population 2,900, in 3 years (see Vox), not to mention millions more to other pharmacies in other small towns throughout the country.  Let's put it this way, if that much crack or meth had arrived in Williamson, WV, in 3 years, every law enforcement authority in the country would have been all over it.  But it was legal.  And all the physicians urged to give them out like candy, and renew the prescriptions at the drop of a hat, for as often and long as... well, as they're asked for.  And why?  Because:  profits.

NOTE:  Meet the Sacklers, the family behind the whole opioid crisis, (Daily Mail - and Esquire), $14 billionnaires and counting, most of which came from OxyContin.  (Oh, and they don't like to talk about it - they're very private people.  Spread the word.)

So, we have two chronic human needs - for pain relief, and to get wealthy - meeting in communities around the nation, and it's all legal.  (At least at first.)  Addiction and overdoses begin to skyrocket, especially as teenagers - who will do anything and everything to get high because that's what teenagers do - get their hands on them.  As people sell them on the black market to make some extra cash.  As people trade them around in search of better pain relief or a better high.  As it all rolls up into one giant white pill shaped ball and pundits ask "Why do people do these things?"  And cluck their tongues like America was such a Puritan paradise before this happened.

HA!  The original Puritans banned dancing, drama, cards, gambling, and most toys, but they did drink.  The Mayflower was loaded with more beer than water, and the very first Thanksgiving meal was served with beer, brandy, wine and gin.  And I'll bet they used whatever they could for pain relief.

And then there's the little issue of withdrawals.  As the Buzzfeed article says, "And once you’re addicted, you don’t take a hit because you’re surrounded by postindustrial despair. You do it because not taking a hit makes you feel worse than you could have ever imagined. If you go long enough without it, you’ll vomit, crap your pants, and want to die, just for starters. So of course you'll do anything to get another hit."  And it's not just opioids.  Untreated, alcohol D.T.s (delerium tremens) has a 15-40% death rate.

Crack cocaine

Now many have noticed that the idea of drug addiction as a way of coping with a life lacking any hope, purpose, or possibilities, was never applied to black urban neighborhoods anywhere.  When the crack epidemic erupted in urban America back in the 1980s and 1990s, no one tried to understand why urban blacks were using crack cocaine in such high numbers, or how a life of unemployment, racism, urban decay, hopelessness, etc., could affect their addiction.  Instead, America got tough on crime, to the point where, "the Anti-Drug Abuse Act of 1986 increased penalties for crack cocaine possession and usage. It mandated a mandatory minimum sentence of five years without parole for possession of 5 grams of crack; to receive the same sentence with powder cocaine one had to have 500 grams."  BTW, poor urban blacks used crack; powder cocaine was more often used by rich urban whites.  5 grams vs. 500; nothing to see here, folks, just keep moving...

So yeah, this whole idea of drug addiction caused by post-industrial despair only cropped up when white people began to become addicts, criminals, and die in epidemic numbers.

Addiction:  From Morality Play to Metaphor of Modernity in only 30 years.  Depending on where it happens, and to whom...

The Age of Stone Surgery

Kidney stones give whole new meaning to writer’s block.

I recently experienced kidney stone surgery. I say this calmly, rationally, as if kidney stones weren't nature’s way of reducing all of us to the level of bawling babies incapacitated with pain.

Literature on the subject appears to have been written by sociopaths who’ve never experienced kidney stones. Take for example this sentence, “Some flank discomfort can be anticipated.” That’s like Germans telling the British during the London Blitz, “Expect a little noise and dust.”

You may have noticed roughly half the human race features external plumbing. Normally, I’m satisfied with this arrangement, but at times like these, not so much.

Now knowledgeable in three techniques, I recognized a need for a bit more depth of the subject matter. Following is my tutorial on the topic.

Kidney Stone Owner's Manual

A kidney stone forms as a crystal, the small ones the size of basketballs. Stones can have many shapes, all of them jagged. One might look like a claw from hell or another might resemble a spiked iron ball from days of yore. Note the wide variety at right.

This is not accidental. Let us step through the history of stone surgery, beginning with a prehistoric account.

Percutaneous Nephrostolithotomy

Ogg and his common-law wife, Uma, lived in the fruitful plains of nowhere important. Ogg had been a good provider, but recently, he’d experienced horrible, sharp pains in his lower back that felt like he’d been clobbered by a stegosaurus tail.

Sometimes the hurt grew so excruciating, he passed out, once with his chin in a patty of dinosaur dung. These painful episodes made Ogg very cranky, much to Uma’s annoyance.

He figured this was nature’s way of telling him to slow down. Ogg decided to turn his attention to the arts.

Uma was a delicate flower, relatively speaking with curvaceous 136~124~136 proportions. Ogg decided to honor his beloved by carving a life-size statue, which ironically weighed about the same as Uma with comparable warmth.

He took up his stone chisel and began chipping away where Uma said it made her butt look big. Abruptly, pain struck. Ogg writhed, saying “Ook-ah, ook-ah,” which roughly translated means “@$*#%€! Holy crap this hurts.”

Uma, who’d give birth to triplets, Gog, Magog, and Agog, didn’t have patience with Ogg’s whinging and whining. She rolled her eyes and muttered about men acting like babies.

But something inside Ogg shifted. Wracked with blinding pain in the throes of the seizure, he inadvertently chipped off a feature of his wife’s sculpture she much prized. Infuriated, she picked up Ogg’s granite club and bashed him solidly on the brow, which not only removed his mind from the pain, but toppled him backward onto his sharp stone chisel.

Out popped a jagged, spiked sphere the size of a megalosaurus testicle. Such were often used as balls in caveman soccer, a very challenging game, especially while still attached to the megalosaurus.

“Oof,” said Ogg, with gratitude and relief. He picked up the spiked ball, hefted it, and muttered, “WTF?” which translates to “What the heck?”

Ogg instantly saw the possibilities and attached a chain to the stone ball and that to a heavy stick, creating the morning-star flail and inventing the phrase ‘my ball and chain.’ Now free of pain and armed with a dangerous weapon, he prowled the plains wiping out woolly mammoths and evangelizing the practice of neolithic stone chisel surgery, now part of urology health care plans everywhere.

Electro-mechanical Hydraulic/Pneumatic Lithotripsy

The next advance in technology moved from stone chisel surgery to deploying a piston that could physically batter stones into smaller pieces the size of baseballs. In practice, a hairy man in a hardhat and full body armor passes a full-sized jackhammer up the urethra where he chips away while humming Sixteen Tons, entertaining the patient and staff. That’s “patient and staff” as opposed to the “patient’s staff,” which is unlikely to ever work again and forever be a source of agony.

Ultrasonic Shockwave Lithotripsy

Bible school students learn the rousing spiritual ‘Joshua Fit the Battle of Jericho’ and the accompanying story, which is considerably more bloodthirsty in the details. (“Listen, Josh, are you sure He said wipe out every man, woman, child, bunny rabbit, puppy and kitten? And babies? And Achan’s family too? You joshing, man?”)

The Israelites marched seven times around the walls, shouted and sang like Yoko Ono, blew their ram’s horn trumpets, and the walls came tumbling down. In urology terms, this is called extra-corporeal shock wave lithotripsy.

That’s how ultrasonic works: You make lots of noise until its volume and frequency crumbles the hard stuff inside your kidney or the building next door. In theory. Some stones it doesn’t work on and it can sure as hell leave your insides bruised and littered like the arena of a demolition derby.

Flexible Pyeloscopy Surgery

Sometime during the Middle Ages, Spanish Inquisitors stumbled upon non-invasive (so to speak) techniques where stones could be tackled by traveling up the ureter. The invention is credited to Bernardo Extirpator XXVIII, a hard-of-hearing and none-too-bright torturer, immortalized by the famous words of his cringing boss as Torquemada lost his cookies. “Pie-hole! Sweet Jesus in Heaven, I said pie-hole!”

One of the conventional techniques has traditionally been ureteroscopy. The procedure is commonly called ‘basketing’ in which doctors playfully insert into the urethra a xistera, similar to the racquet used to serve 180mph pelota balls in the game of jai alai, except the medical device is about the size of an ordinary laundry basket. This doesn’t give the procedure its name, but afterwards the screaming patient is carried out in a basket.

Rigid Ureteroscopic Lasering

Basket extraction fell out of favor with the advent of Star Wars technology. A ureteroscope, a long, thin peeping device the size of a 37-inch television is sent up the ureter to determine where the stones set up camp. Once located, surgeons call in the big gun, a holmium laser-blasting weapon affectionately called Battlestar Galactica. It vaporizes the stone and the rest of a patient’s resolve not to scream like a 3-year-old.

Note ureteroscopic lasering is not the same as ureteroscopic tasering, invented by Bubba Joe Hadcock when he sat on his newly acquired stun gun. It was subsequently discovered, thanks to his invention, Bubba Joe didn’t have nor ever will have kidney stones. Nor kidneys for that matter. A simple solution to a complex problem.

Clonal Lithography

In its simplest form, the patient’s body is amputated to stop the pain and a replacement grown. Medical technicians cryogenically freeze a patient whilst a clone is fabricated. Conversely for advance planners, a clone may be prepared beforehand and itself cryogenically preserved.

In an in-patient, minimally invasive procedure, the encephalon is transferred in toto to the brain-case of the new host. Patients have been known to immediately resume texting, shopping, complaining about The View, and other normal activities.

The Stent

“Out-patient,” I thought they said but it was “Out-of-your-freaking-mind-patient,” talking about the stent removal. See, at the time of stone removal, they put in a piece of tubing like 3-inch industrial wiring conduit. In the wretched days after blasting the kidney stone, a stent allows pieces to pass through. Sometimes medics issue patients strainers in case the spleen or forgotten medical instruments fall out.

So Dr. Steven Brooks and Nurse Wendy corner me in a room where I hold them at bay with an impromptu lion-tamer chair. It's a swivel chair with spastic casters that would make any self-respecting lion roar with laughter, but my crazed appearance gives them pause.

Dr. Steven Brooks and Nurse Wendy tell me 99% of tough, be-all-you-can-be men opt for out-patient removal of the stent and only a wussy 1% choose being knocked out for hospital removal. Psychology is at work here: As the army knows full well, at the root of male bravery is fear, fear of showing fear. Otherwise, 99% would sensibly choose to be knocked out and wake up the following month fully healed.

So I say okay and put down my improvised lion-tamer chair with its twitching casters. I eye a previously laid-out, sadistic device that looks like an automotive parts retrieval tool, a flexible shaft with a spring loaded handle at one end and a three-prong claw at the other. Silly me, I look at this thing and naïvely wonder how it will slide up.

I say naïvely, because I didn’t realize they would insert yet a terrifyingly larger tube sized to accommodate not merely our automotive parts extractor but a full-grown ferret. I look at the diameters and realize someone hasn’t done the math. A shop vac hose can’t possibly fit up an opening the size of a soda straw, and if it could, no one would ever again sip from that straw.

@$*#%€! Holy mother of …!

Afterwards, I asked them to just let me lie there a couple of weeks to recuperate as I write these last few words and my will and testament. I hope this technical dissertation helps my fellow layman and laywoman. Meanwhile, my bladder’s shrunk to the size of a pea… Whoops! Wrong word. Gotta go!