Wednesday, September 22, 2010

Dream

Along with all the rest of humanity, I watch as a gigantic sphere approaches, slowly. It is very far away and hazy, but as it comes nearer it looks like a huge mirror ball, twisting and glinting, its surface reflecting from billions of small facets.

Oddly though, the closer it comes, the more it sizes itself down to human scale; finally it lands, softly, small enough to fill a small room, easy enough to approach now.

I approach, fueled by my own curiosity, without any fear.

Once up close I realize that what looked to be small mirrors from a distance are actually face-sized windows, through which one can peer in. I find a window. I peer.

I see nothing but a big slow swirl. My sense of disappointment tells me that I must have picked the wrong window. Others are peering in and have become fascinated by something, riveted to their view. I conclude that there must be a certain window for each human, a unique view for every individual. Yeah, that's it - I simply haven't found "my" window yet. Nobody is fighting over windows, so there must be one for everybody, there must be one for me somewhere. I move about, examining available windows, looking for the window through which I'll be able to see whatever is in there that people are exclaiming over.

Finally I find my window. When I look in through it I see all of human history and past that all the way to the beginning of time. The view is strangely telescopic and wide-angle at once, and I can see all the way in to the center, the start point, and all the way out to the surface, the present moment; I can stop at any focal length to examine any point in time I want.

This must be it. This must be what others see, and are busy looking at.

I see a species called human, which has evolved and took its place recently and to which I belong. It is unbearably maladapted to the planet, physically and emotionally maladapted, yet has spread all over it.

I see when it lost its fur. This was a very pivotal wrong turn. At least, as I see it, through my window, that's how it looks. From that point the expansion was more than just gustatory survival - it looks as though it was a starting point for what follows, a planetary expansion that has been based on need, greed, and in more recent days, making the earth bleed by sucking out as much oil as humanly possible. The liposuction of the planet until it begins to heat, and cave in on itself. Pretty gross.

I see that religion might have started out as a well-meant coping mechanism, a cultural adaptation to try to keep peoples' minds off their own individual fates, a distraction from the pain of realizing that once born, we're all stuck here until we die, forced to scratch out a living by using up a planet. It looks like it accelerated along with everything else though, and, from my perspective, through my window, backfired; it turned into an accelerant instead, serving to zombify rather than merely assuage, justify rather than clarify, lubricate the "descent" of humanity as it continues creating "hell" on earth, rather than support individuals as it was intended. I see science as a cheerful, determined attempt to mop up, but mostly after the fact and mostly also having become another accelerant. It seems no matter what humans try, what seems like maybe it was a good idea at the time becomes institutionalized and exploited to turn the process into more and faster destruction.

I wake up.

Saturday, September 18, 2010

Life at a basic bio level

So, today as I surfed around I fell into reverie about life at its basic biological unit, the cell. Not just the human cell, 300 kinds on the spectrum from most structural to most signally (i.e., meso to ecto, meat/bone to brain), but this time, how foreign bits of life invade, how our culture assists this to our occasional individual detriment, how we are basically just walking condos for microbial life, how apart from just an occasional sense of dismay, I've learned to accept all this and mostly roll with it.

This story from Superbug blogger Maryn McKenna, about brain amoebas contracted by innocent transplant recipients from organs obtained from a donor who had died from encephalitis got me started. Then, I tracked through a few of the other Superbug blogposts and found this: Outbreak of superbugs: The Singing Doctors (a youtube video). Apparently these guys go on tour, putting on musical shows about the US health care system. This seems absurd to me; but then, I'm a Canadian and there are many, many things US that seem absurd to me.

If you haven't thrown up enough yet, check out this: picture of baby licking pig's snout - eyeeeeeew. Talk about exposing your immature immune system to all sorts of adventure so that it can develop itself into something robust...

Microbes certainly have a way of having their way. I have a feeling long after we're gone (as a species) they'll still be around, no doubt inventing new forms of warm, anaerobic habitat they can drive around and symbiose with, completely supported by evolution, respecting all the laws of thermodynamics.

Tuesday, September 14, 2010

Ronald Melzack and the Canadian Physiotherapy Pain Science Division


It's good to have long term goals, right? One of mine is that every PT on the planet eventually be exposed to Melzack's neuromatrix model of pain (5 page pdf), and learn to see being a PT as equivalent to being a neuromatrician. Another goal is to have every manual therapist realize the two main input domains* of a neuromatrix they can favorably influence, and why it's important to be careful what is put into them, and how. A third is that each therapist would operate from a working knowledge and awareness of his or her OWN neuromatrix while working on another's (interactor model of treatment), and not merely from recipes and protocols and paradigms that elevate structural tissue above signaling tissue (operator models of treatment).

With this as the backdrop I attended a reception at the recent IASP Congress in Montreal, to celebrate the lifetime contributions of one of Canada's most famous if not THE most famous of pain researchers anywhere, Ronald Melzack.

He had not met us before (except perhaps Dave), although he wrote a message of support at our request back when we were trying to organize a proposal to become a Pain Science Division of CPA. A line of people were wishing him well as he made his way out of the room after the reception. He was moving toward a larger brighter lobby for some pictures with all the grad students he had worked with over the years. I positioned myself at the end of that line, introduced myself and told him who we were, thanked him for all the work he has done in his life, remarked that I would like all physiotherapists to become neuromatricians, asked him if he would be willing to let us have a picture with him. He was very gracious and more than willing. It was the highlight of the trip to Montreal and perhaps my whole life. I can now die, anytime, a happy woman.

* Cognitive-evaluative and Sensory-discriminatory

Wednesday, September 08, 2010

Snippets from IASP

Luggage finally arrived home yesterday. This is good, because all my notes and materials from the Congress were in it.

Pain Mind and Movement Symposium
A whole day of presentations, lots of science, lots of graphs, lots of dark slides of graphs in a dark room. I gotta say, there wasn't as much zip as I would have preferred. Some presentations stood out, like that of Michael Sullivan who is looking at how to test for a sense of "perceived injustice" in injury cases, teasing out the manner and degree to which it impacts a pain experience. He used video clips - much more interesting than plain old power point. Maureen Simmonds showed video clips of her movement lab - she uses virtual landscapes projected onto walls and tries to determine if illusory surroundings have any effect on perceived pain or effort while walking on a treadmill. Catherine Sabiston talked about mastectomy patients and dragon boating, and something called post-traumatic psychological growth, but not pain specifically. It sounded like if everyone would just bond while being active no one would care if they had pain or not. I don't know - I'm sure there's something to this but I'm also pretty sure that not everything emotionally or physically or socially painful is due to dragon boating deficiency.

There was a break for lunch, which turned out to be lunch from a box, not the most inspiring lunch I've ever enjoyed. Several of us gathered round large round tables. I sat with some people I knew from being online and a young woman from England I had just met. The conversation roamed around and landed on the topic of pain and biomechanics, something I have done some thinking about. As we talked about how to uncouple the two ideas to free the minds of PTs from the shackles of conflated thinking, the English girl said, well, wait a minute, I have a foot pain, and it goes away when I slide T12 to the right over L1. I couldn't let it go by: Really? I asked; Do you think that's the only thing going on in your body that matters, is that you move a few bones relative to each other? How do you "know" you are even doing that? I was questioning her assumptions but she responded as though I had punched her in the gut. She replied that that's what she did, and it took away her pain. I looked at the others and said, mesodermalist. A lively discussion followed but the English girl might as well have been listening to jabber from an alien planet, because she knew what she knew and what she knew was fine by her. Or something. I think she's another meme victim of "motor control." I checked around and see that she wrote a chapter in a book about movement published in 1998. She's been attending congresses like this, one presumes... maybe she still imagines that other innervated tissues in the body, besides bone and muscle, don't matter to the brain. Maybe she's never considered that physically therapeutic ways to approach the problem of pain exist, might include a bit of, but are in no way restricted to, "motor control". It's the 'blinkers attached to the side of the head' problem I've seen ever since I started up in this profession 40 years ago.

The afternoon session included more dark powerpoints in a dark room. The final session was a "roundtable" - a refreshingly lively microphone session where anyone who wanted to take the mike could. Steve George started off with a confession that he was a recovering biomechanist. He had presented earlier but I probably had zoned out by then on all the powerpointage - my ears were sharp now however. He was followed by a bunch of other fed-up people, all on a similar page about the state of PT and what could be done about putting pain further forward in the focus of the profession. I didn't get up at the mike - I'm more interested in what others more eloquent and extroverted than I have to say, and I'm better at writing than talking. It was great to be there and realize how not alone I am in my disquiet.

The wine and cheese slated to follow the day had been canceled.

Sunday, September 05, 2010

IASP in Montreal - post event snippets

This is a series of little personal and professional snippets, vignettes, from the IASP Congress, held in Montreal Aug. 29-Sept 2 2010.

Lost luggage (again..)
I got back Friday afternoon (Sept 3), minus my luggage, lost somewhere in the bowels of Toronto airport by Air Canada in connector flight limbo, for the second time in 4 months. It has yet to arrive - the first time it was lost by Air Canada as I came home from Brazil, it arrived the next day. This time the wrong bag appeared at the bus station. Someone else must be in Air Canada luggage hell with me, our suitcases delivered to each other. This is getting very stressful. No more Air Canada for me I'm afraid. I'm already going through a mourning process more severe than should be necessary - especially once I realized I had packed my notebook FULL of scrawled notes taken at all the presentations. That really sux. The clothes? Meh. The shoes? Meh. Replaceable. But the two hard cover books, a dental pick, favorite scratchy Japanese bathing towel, MUCH harder to replace; the bamboo back scratcher that was my dad's before he died, and the note book (!) - irreplaceable!

The Melzack reception
It was the first time I'd ever been to an IASP Congress, ever. I knew they occurred but this time I wanted to go specifically to attend the reception for Ron Melzack. I not only was in the same room as he was, but I got to meet him, shake hands, and have a picture taken with him and the other members of the CPA Pain Science Division who attended. The photographer is a retired neuropathologist married to a Canadian pain physio we know, who said he'd email the photos but hasn't so far. When he does I'll post one. This event is the highlight of my life so far.

John Loeser presented a slideshow of Melzack's life and work, lots of photos of his childhood, family, vacations he was on, people he met and worked with, with lots of hair and without, all the way from age 10 to now. I was previously unaware Melzack had written books of stories of the indigenous peoples of the far north. He was there with his wife in her wheelchair, gracious and charming, shorter than I had expected. There were probably close to a hundred people gathered, beautiful food, plenty of wine, lots of huddle around the guest of honour.

I really wanted to say hello to him, saw that there was sort of de-reception line had formed as he tried to make his way out the door into a larger foyer for a planned photo with his "family" of grad students. I walked over and waited a turn. When he got to me it was clear on his face he had never met me before. He extended his hand anyway. I rapidly introduced myself and reassured him we had never met previously but that I was very pleased to meet him, that I was with the physiotherapy Pain Science Division, that I wanted to thank him for his life's work, that it was already having a large impact on my profession and that if I possibly could I would want all PTs in the world to become conscious neuromatricians. I asked him if he would be willing to have his photo taken with those of us from PSD who were there, and he graciously nodded. And then it happened, out in the lobby, after the more official photos were taken.

SomaSimple thread
A SomaSimple thread was started while IASP Congress was happening, to which we posted highlights (and some photos) when we had time.

More to come. Much more.