Friday, May 20, 2016

Society vs: culture vs: chronic pain

It is not without a bit of trepidation I tackle all this awkwardly, for I barely know what I'm talking about... it's been a very very long time since I've sat in a sociology class soaking it in or have involved myself in political aspects of life. However, I have opinions after being alive this long. And this is my ancient blog that no one reads so I'm safe to express my klutzy ideas here.

Part I: Prelude: 

Lately I've been pondering the difference between society and culture. There is a difference. It's political.
The one demands conformity to be able to perpetuate itself, and it does so by oppressing the other. If it cannot oppress it covertly, by persuading its members there is no difference between the two, then it oppresses overtly. It doesn't really care.

For example, society and state usually overlap, completely.
Society goes on forever until or unless toppled.
Voting is actually the way the state maintains itself; it doesn't matter who you vote for - the government will win. So, allowing voting was a clever move: it is a way for the state to pretend it is a democracy, so it doesn't get toppled.

To be sure, toppling the state would mean generations of anarchy and turmoil and maybe a series of dictators or militarist gangs or a theocracy springing up. Most of the culture and subcultures, e.g., women, anyone who is coloured differently than the dominators, has a different set of values, language, religion, etc.etc., would be worse off than ever. State-toppling is not a good alternative.

The rules are in place to keep everything running smoothly, and in our society, to keep money flowing away from producers and toward hoarders, who generally can change the rules to suit themselves, and who are generally old white males.

Culture is ever-changing and growing from the grassroots; it is forced to adapt to society. If your culture doesn't fit the society, or adhere to its values, you are by definition an outsider.

Political parties (the old established ones, at least) represent the poles of differences between society and culture. For example, conservative parties, when in power, squelch down on culture and anything related to the well-being of ordinary people by pulling back on funding or else refusing to fund it at all. Example: Here in Canada, conservatives were in power for a decade, and managed to cripple state-funded health care, research, and a lot of other benefits to taxpayers. They massively propped up the oil economy. They did not manage to get Canada completely out of debt, the thing they had decided well in advance was the most important thing. They seemed eager for war.

Ordinary people who vote for conservatives think they are the most rational; they want to preserve social order and maintain or improve status quo. They usually place any needs of heterogeneous groups of people way down on the list. They fear change. They tend to view themselves as parents who support the state as ultimate parent, and anyone else who is, or thinks, or votes any other way as childish. They are a bit like the stern dad, who goes for the gusto and to hell with anybody who gets in his way.

In Canada, last fall, they got booted, and the other pole was elected. Liberals are now in power.

Liberal parties do promote culture as well as state. They are two-faced that way. Which is why conservative voters don't trust them much. On the bright side, they operate from an egalitarian position - that everyone is equal and adult with varied concerns. Like the mom, they want everyone to be as happy as possible.

Liberal voters are often immersed in a let's-feel-good-now way of existing and living. They do have a point - life is short and then we die, so there should be something to help slide us along easier than pointlessly sacrificing and suffering while we're here. They tend to see the state as a parent and themselves as dependents.

They managed to convince the public they would move the country forward by removing cultural obstruction that had accumulated the previous decade. They would shift the cultural landscape. They would restore funding to everyone. They would right old wrongs and heal rifts between state and cultures. They would make sure everyones' social well-being was not only restored but their interests furthered. To cut them some slack, for sure, they got right to work on a lot of projects to soothe cultural feelings and relieve some of the cultural oppression, some of which have been accomplished and others that are still being worked on. Here is the Trudeaumeter that makes it easy for regular people to keep track of the progress being made by the Canadian government. They are planning to legalize marijuana, for example.

One of the things that had piled up, that the conservative party had put way way down the list, was right to die legislation. Which leads us to the next part of this post.

Part II: Right-to-die

Now in my mid-60's, and part of the baby boom that strained every resource the state ever had in place and ever had to install to accommodate such a large increase of an age demographic, I got kind of used to the state accommodating me and not the other way around.

My personal fantasy is that by my end of life, there will be little kits you can just order at the drugstore, whether by prescription, because let's keep doctors inside the loop, or over the counter if doctors don't want to be kept in a loop. I will be done. Not imaginary thy, I.
I might not be sick, but I will be done. With living.

I will be able to go get a kit, or else, if I'm disabled somehow, I'll be able to get one delivered.
I'll call the ambulance, or whatever societal transportation method is officially in place by then, somebody aboard with rights to pronounce death, to produce an official death certificate that will tell society I'm gone and to stop sending electrical bills to my address, notify my relatives, etc..

I'll tell the transport what time to come and pick my body up. I'll leave the door unlocked for them. I'll crawl into and lie down in the tub: in case the ambulance is late, I don't want any body fluids to leak onto my condo floor and ruin its resale value and leave a lot of bother for my indirect (as in, I have no direct) descendants to have to deal with. I will take the potion. I will go immediately unconscious and won't feel a thing. I'll simply go dark.

The transport will take my carcass off to the crematorium.
No mess no fuss.
No huge medical bills.
Low carbon footprint.

I realize this seems macabre, a bit; it seems that way even to me. But in another 20 years? A lot of us will be dying off all at the same time, and it seems reasonable to try to think of ways to save society money in advance. Think of all the children.

Part III: Drama in the house

So, the other day, the government and the parties in the house were all faced with having to parley through all the stressful taxing hugely socially responsible topic of having to come up with something on the issue of right to die for the Supreme Court of Canada, who had struck down the law against assisted dying, earlier, and had imposed a deadline for new legislation.

This is something the conservatives would not ever have come near with an eleven-foot disinfected barge pole. But the liberals? it is a cultural thing, something they had already promised to deal with, so it was theirs to stickhandle.

The deadline was the rock, conservative opposition was the hard place, and the Liberals were up against the clock. Yes, the NDP, the party of progress, was involved as part of the hard place too, but here is why. The Liberal party, the official government with a massive majority of seats, had looked at the situation, the deadline, all the other stuff they still had to get to, and decided to do this thing that the governing party can do if it chooses, which was to close debate and move on.

But: opposing parliamentarians did not like that idea. They wanted to slow things down a bit. The NDP behaved kinda badly by forming a physical crowd barrier to a conservative who had to get to his seat before discussion could resume. I have no idea if that is even legal. But they did it. And Trudeau got a bit annoyed.

Trudeau is not an old white guy. He's a guy, and he's white, but he's young, and he's a boxer.

Maybe he comes by his reaction to being stalled, and what came next, honestly: His father was somebody who gave the public his middle finger when he became annoyed. He swore at other constituencies, then later claimed he had said "fuddle-duddle."

So maybe it was genetic. Or maybe J. had a testosteronic moment, was a temporarily so stressed alpha male human primate that he lost it. Maybe it was all the boxing. Maybe it wasn't.

Whatev' the case, he got mad, he marched down and broke through the knot of people, went after the conservative. He knocked a female NDP MP in the chest accidentally in the process, with his elbow.
For more re: the kerfuffle that followed, see Trudeau's elbow neither the beginning nor the end of Liberal troubles, by Chris Hall.

To the public, and to the media, it was like mom and dad were having a fight, and it had got a bit physical. Needless to say the issue of the blocking and whatnot mushroomed and completely eclipsed the business of dealing with legislation. Maybe nobody was really ready to get on with dealing with something so fraught with opposing viewpoints, soul-searching, and the pressure of time, as legalizing assisted dying is. For more, read Know what's deeply traumatic, Elbowgaters? Needing assisted dying.

Part IV: Dying of pain

OK, finally the topic has meandered around to something I'm keenly interested in and have been since forever, the topic of pain, how the issue of chronic pain is woven into a societal tapestry, and suffering from it therefore if it counts as enough of a "thing" to be a legitimate reason for assisted dying. The topic is starting to be addressed by PT bloggers. See Tim Cocks' post, The ultimate pain killer. 

One of the biggest aspects of pain is that is feels like it will kill you, yet it never will. Because it can't. Because it's only a perception of a sensation. It's not a real "thing" - i.e., it's not an actual medical condition stemming from an actual problem with an actual tissue, the way the biomedical model assumed it was, and would still like it to be.

Yes, there are biomedical aspects to it, physiological glitches, genetic components, neuroanatomical peculiarities sometimes, perhaps: but they aren't diseases and they don't kill you either. Pain makes you feel like shit. Then (if it won't go away on its own, or you can't find someone who can help you by using a variety of placeboic, non-specific tricks, like manual therapy, which only works for the most basic kind anyway, which fortunately is also the most common), have to learn to deal with it. Live life in spite of pain. There are LOTS of helpers to help with that.

While I am somebody who does my best to alleviate pain, with my life, and work, and advocating, I think there are things definitely worth thinking about:

  1. The risk of un-assisted suicide in the chronic pain population is high. See Completed suicide in chronic pain. 
  2. The rate of un-assisted suicide in the chronic pain population is high, by opioid overdose. See Depression, chronic pain, and suicide by overdose: On the edge. 
  3. 50% of chronic pain patients have depression. See Suicide attempts in chronic pain patients. A register-based study. 
  4. Migraine, back pain, and psychogenic pain (whatever that is) are linked to higher suicide risk in vets. See Certain chronic pain may raise suicide risk.

Part V: What should I make of all this?

OK, here goes:
  1. I'm more of a liberal than a conservative. (But I do not vote liberal - I'm more leftoid than that.) 
  2. I can see the point of there being an ebb and flow in society, with conservatism being in power once in awhile. But not too much for too long, thank you. (I do not vote conservative, I'm way more leftoid than that. )
  3. Still, I hate when society oppresses cultural flowering. I'm a member of a few oppressed groups in society, myself. With the help of institutionalized white privilege, though, and women's rights groups who made a lot of societal progress before I was born, and while I was still a child, I made it through life reasonably well as a single female who was never turned into a uterus with arms and legs, whether by societal expectations or cultural trap. 
  4. While I've never been, and never will be, rich, I don't care: to me that is not the point of living, and as long as I can pay the bills and save enough to live on for when I become feeble, it will all be fine. 
  5. I think the point of living is to work hard to figure out how to live without harm to self and others, and try to leave the world a little better than you found it, if you can. And not by merely reproducing and just hoping for the best. If you are going to have children, raise them without harming them in the process. (Frankly, I'm glad I never had any, because global warming.)
  6. I appreciate forethought and planning by society to keep societal services intact. I do not mind paying taxes to those objectives. I could never live in a country that did not look after its citizens' hospitalization and health care, that instead does not care if they become impoverished by accident. 
  7.  I do not have any political or moral objection to assisted dying. I would want "society" to care for my suffering the same way I cared for my beloved cat's old-age suffering; I arranged for her to be put down. 
  8. I do think that pain drives people to kill themselves. 
  9. I do not think pain is very well understood, yet, by society itself, or by any of the cultures oppressed by society, or by very many of the unfortunate members of oppressed cultures under a dominant society who experience pain chronically. 
  10. If you have chronic pain and are a member of an oppressed group, your pain may be worse and you may receive less help for it. Like if you are female. Because biomedical studies are usually done on male mice and human males. 
  11. If you are female and do not have white privilege,  you are doubly unfortunate, probably. 
  12. Once marijuana is legal, there will no doubt be a lot of studies on its effects on pain. 
  13. Maybe once it has been made legal and people are free to smoke it, pain will either be decreased, or else people will be distracted enough from pain, among other things like social oppression, that they won't commit as much suicide for all the reasons they currently do, un-assisted.
  14. Maybe the issue of assisted suicide for chronic pain will go away, because a legal tool (marijuana) that allows people to space out and assists them to invent then have a life in spite of pain, will cancel out their wish to cease living before they are done, physically. Then assisted suicide can be in place, less tendentiously, for actual already-recognized diseases that people want to die to get away from. 
  15. Maybe everyone will go even more nuts than we already are. But perhaps we'll be less stressed out about all of it. 
  16. It has never ever been easy to be a self-aware human primate and juggle all this hierarchical social structure and find a way to live with it all. It never will be. 
  17. Meanwhile, global warming. Trudeau is working on that too, or at least, promised he would. 

Here is what I think might help them all get back up on track: Trudeau (and his wife along to chaperone), arrange to visit her office to (hopefully) meet with her, or if she won't meet with them, drop off flowers and a beautiful handwritten note apologizing yet again, asking her forgiveness, etc., for the final time.
Then get back to business.

ADDED MAY 21: 'Elbowgate' has made mountains out of molehills.
I agree: "Jack Layton would not be pleased."

Wednesday, May 18, 2016

Dangling no more

Done with dangling

At last. 
Way behind the imaginary schedule I had in mind but failed to live up to. A year behind, actually. 
I finished the book slash treatment manual slash deconstruction of tissue-based operative treatment models and have sent. It. In.

Not that there won't be dozens of little mistakes and tweaks needed and maybe even rewrites. But at last, I found the flow that was so elusive. And I managed to get everything in that I wanted to say.

That inability to follow the schedule I thought I should stick to is OK, because it had been arbitrary in the first place. I satisfied the main itch, which was more important: to say what I wanted to say and how I wanted to say it.