There’s No Modesty at the Urologist

James Wallace Harris, Wednesday, July 15, 2020

I awoke from the anesthesia with a tremendous urge to pee. I might have already been telling the nurse that before I was conscious because she was holding a plastic bottle up to my penis. I was trying to get up and she was urging me to lie back. I was in the middle of the action and not remembering why. Then I recalled I had been put under general anesthesia for a biopsy on my bladder. The last thing I remember was the oxygen mask.

I desperately wanted to pee, but the only thing going into the bottle was thick blood. My mind was clearing fast and I realized my hope of getting home quickly wasn’t going to happen. We had arrived at the clinic at six for a seven o’clock procedure. The clock now said eight. Susan and I had talked about how great it would be if we could have gotten home by nine.

That wasn’t going to happen. Something had gone wrong. All I could think was “I wish I wasn’t here” but I knew my wishing was wasted thinking. I wanted to pray, “God, get me out of this” but I’m atheist and I knew my prayers wouldn’t be answered even if I was a believer. I had to deal with things as they were.

I could not escape my situation and I knew how I handled it depended entirely on controlling my thoughts. Pain is so focusing. It was unreal waking up in this bizarre situation. I told myself this was just a bad trip I had to ride out and what I was experiencing was nothing compared to all the thousands of Covid patients were experiencing, much less people having cancer or heart attacks. Don’t whine, deal.

Still, I was doubling up in pain telling the nurse I had to go. She kept saying, use the urinal (which was only a plastic bottle). I told her it might help if I could sit on a toilet. I was in a recovery area with four or five bays behind curtains where patients were either being prepped for surgery or recovering. I thought for a second about modesty and then didn’t care. The nurse help wrap me up in my hospital gown and walked me to the bathroom. She put a plastic catcher over the rim of the commode before putting down the seat. She told me to pee into it because the doctor would want to see the results.

It was somewhat calming to be sitting in the bathroom by myself. I kept hoping pee would flush out all the blood, but it didn’t. All I could produce was blood as thick as Campbell’s soup just out of the can. And no matter how much blood I produced didn’t relieve the overwhelming urge to pee. I knew I needed a catheter and that’s something I’ve always dreaded. Again, it was all too obvious that what I wanted and what would happen was two different things.

I knocked on the door to get the nurse and told her it was no luck. She took me back to my bed and I begged for a catheter, but she already knew what I would want and need and had one ready. She asked if I wanted to be numbed first, I told her no, just do it, that I was dying to pee. So, she did. Six hours later, after flushing three bags of water through my system to clear out the blood I was able to go home with a catheter still in me. Unfortunately, this was Thursday and it was a three-day weekend because of the 4th of July. I’d had to live with the catheter until Monday.

Those four days were very educational. Pain is the perfect Zen Master. When a student’s mind wanders the Zen Master will whack their shoulders with a bamboo cane. The tube up my urethra would zap me with pain if I didn’t pay perfect attention. Luckily, the bladder spasms would only last five to ten seconds. I’d have to clutch something and kick the floor until they stopped.

My purpose here is not to bellyache about my pain, I know too many people who suffer far greater. No, I bring up this yucky incident to show how it affected my thought processes. The first title I had for this essay was “Thinking Clearly.” But I decided it was too boring to catch people’s attention. Then I thought of using “Pain is the Zen Master” but doubted it would attract much attention either. Then “There’s No Modesty at the Urologist” came to me and knew it was the kind of title that some people would click on. One of my most popular posts was “Losing My Modesty” about when three women holding me down to cut off a skin growth near my genitals.

I realized while in recovery that I needed to think clearly. Panic, fear, self-pity, anger, bargaining would not get me out of the situation. But neither would magical thinking of wishing or praying. And I realize that many of my thoughts were delusional or led to false assumptions. Making imaginary bargains, extrapolating from poor data, or speculating about the possibilities just generated endless possibilities that would never happen.

Let me give you one concrete example. Because I had a pain spasm every time my catheter was pulled or pushed I imagined that it was stuck to wounds within my urethra where healing and scabbing was taking place. I worried that pulling it out would be immensely painful, reopening the healing sites. I feared I’d need another catheter put right back in. I worried and thought about this for three days. Then Monday, the doctor pulled it right out with no pain, no fuss, and no bleeding. In other words, I worried for nothing.

In three days I theorized about endless possibilities — both positive and negative. Most of those thoughts was wasted thinking. As I wrote about earlier in “Expecting the Unexpected” I can’t predict the future. We can observe data to a small degree and act on it in small ways, but not in significant ways. For example, as my urine bag filled up I’d feel the need to pee. It would wake me up in the night just like when my bladder fills up. But I knew when I opened the tap on the urine bag the draining out of the urine would make a suction that caused a pain spasm. I deduced if I disconnected the bag’s hose to the catheter first that suction action wouldn’t affect me. That’s how far I could predict the future. Not much, huh?

Another example, I went back to the urologist on the 13th to hear the results of the biopsy. Of course, even though I’m not superstitious, I worried that might be a bad day to hear the report.

When the doctor told me I needed a biopsy weeks ago I realized that any speculation would be meaningless until I got the results. The answer would be like Schrodinger’s Cat — unknowable until I opened it. On the 13th the doctor told me the biopsy was clear. That was a huge relief. I can’t say I didn’t worry, but not much, most I spent a lot of time trying to imagine what I would do if the lab report had been positive.

We all think too much. We have so little control. We want to believe we have magical powers to control reality with our wishes, but we don’t. I know this, but I still wasted a lot of time on endless useless thinking. Another example, while waiting for my results I craved sweets, but I was afraid to eat them because I thought it would cause the biopsy to come back positive. When I saw the floor was dirty I thought if I don’t sweep it immediately my biopsy will come back positive. I know such thinking is crazy, yet knowing that doesn’t stop such thoughts.

We live in a highly deterministic reality even though we want to believe that mind over matter works. Religious people use the word faith but it’s use is not exclusive to theology. Throughout this whole process I kept trying to outthink my doctor even though I know nothing of urology. The reality is I have to put faith in modern medicine. I can’t think my way around it. I don’t have any alternatives. I’d love if prayer work and a personal God was taking care of me like my nurse, but there’s just no evidence for that. I’d love if I had great mental powers so my will could alter reality to my whims, but there is no evidence for that either.

Even the simple desire for modesty was beyond my control. My nurse saved me that day. She attended to all my needs while also helping others. She rushed from bay to bay but was always there when I needed help, which was often. She didn’t always close the curtain and I thought about saying something, but I realized it was too petty, too nothing. It was only my thoughts that made me worry about modesty. So I let it go. If people walking by wanted to look at me I didn’t care. Actually, I felt sorry for them having to see a old guy with a bloody tube coming out of his dick. That must have been revolting.

When it was all over I understood it was just a big painful inconvenience, the pain had been bearable. I could survive because I did. At the time I told myself I never wanted this to happen again. I still need my prostate trimmed, so I need to go through this all over again. And I will.

I don’t know if I can apply the lessons I’ve learned to the next time. I might still worry needlessly, still try to bargain, pray, read omens, and act on superstitions. The reality is we might never be able to control our thoughts even when we know they are wasted thoughts. Can we ever just accept reality?

This Covid crisis is a parallel example. Too many people want to reject reality and act on magical thinking. I keep hoping our whole society will become rational and think clearly, but isn’t that wishful thinking too? Especially, if I can’t think clearly myself.

JWH

Have You had BPH Surgery?

by James Wallace Harris, Saturday, May 16, 2020

I need BPH surgery and have been researching TURP and Urolift procedures. I’d prefer to have the Urolift since it’s less drastic, but I’m not sure if it’s a long-term solution. It’s only been available since 2013. TURP is considered the gold standard procedure, but it has several potential nasty side-effects.

If anyone had either procedure and willing to share their experience or advice, please leave a comment.

JWH

Emotional Reactions to Pandemic Times

by James Wallace Harris, Friday, March 27, 2020

Psychically, our nation, our world, has made an abrupt U-turn. The stock market was soaring, unemployment was at an all-time low, and everyone was running around the planet doing everything they dreamed. We thought we had a handle on the future. Then BAM! Now we’re all huddled in our homes fearing the grim reaper and hoarding ass-wipes. (Of course, this ignores all the other forms of endless suffering so many humans were already combatting.)

We all want to get back to those tomorrows we were planning just a few weeks ago. I imagine the emotional reactions to the pandemic vary greatly, especially by age. I am 68, going to turn 69 this year, and I was already feeling oddly emotional about getting close to my seventies. The growing aches and pains of aging, as well as the deterioration of my various organs and digestive system, was already leading me into gloomy thoughts about the future. Running out of time has become more and more inspirational, but when the plague hit, that emotion went into hyperdrive.

We are experiencing something very new and different. It’s not that humans haven’t been on the brink before, or that we don’t think about it often, but we’re getting to feel it for ourselves in a very intimate way. Last night I watched the first episode of The War of the Worlds on Epix, where billions of humans are wiped out by invading aliens. I’ve read books and seen shows about apocalyptic events countless times in my life, but watching this one last night felt more realistic than ever before. The worse this pandemic gets the harder it will be to vicariously enjoy fictional apocalypses in years to come. The Great Depression and WWII inspired a lot of fluffy fun films in the 1930s and 1940s.

We still don’t know what this plague will bring. It could be over in weeks, months, or years. We don’t know how many lives it will terminate, how it will change the economy, or how it will alter our future daily outlooks. Essentially, it’s fucking with our sense of the future. What I love, and I imagine most of my fellow humans do too, is normalcy. We want orderly lives that we can control and predict. Remember, “May you live in interesting times” is a curse. Sure, there is a percentage of the population that are thrill-seekers, but most of us are not.

I was already stressed out for political reasons. The plague has both trumped Trump and swept away the 2020 election. I realize if I had the psychic energy I would ignore both and get on with my plans. I can pursue all my old ambitions at home while sheltering in place. But the dark clouds of rapidly shifting futures disrupt my thoughts. I assume they do you too.

If I was Yoda I suppose I could separate thinking from my emotions, but I’m not. The fear of being put on a ventilator keeps me from mentally seeing straight. And the fear of Donald Trump being elected a second term still eats away at my sense of wellbeing. If I had Zen Master mind-control I’d phase out these psychic ripples caused Covid-19 and Trump and get on with business. Unlike Trump, I don’t think we should all plan to go out by Easter. On the other hand, until the virus grabs me, I don’t think I should sit around and wait for it either.

The reality is I’ve already got other age-related health problems. Worries about the pandemic just exacerbate them. My health is easily disturbed by disruptions in my diet, exercise, sleep, and thinking. That wasn’t true, or not apparently so when I was younger. All of this leads to the realization that controlling my emotional reactions to the daily news is vital to my health. At 68, staying positive is critical. Fearing the future is just as dangerous as actual viruses. What we want is to act on the now to bring about desired futures, rather than wait in the now for scary futures.

When I was young I used to tell people I never worried about getting old because I didn’t fear wrinkles and going bald. I thought being old was all on the outside. I never imagined the psychic components of aging. What getting old is teaching me is the breakdown of consciousness is scarier than the breakdown of the body. Of course, they go hand-in-hand, but ultimately we need to fight for mind over matter.

What the plague is teaching me is how positive emotions are tied to our planning. And experiencing a plague later in life combines two very similar storms of emotions. I used to think I was like Mr. Spock, all intellect and no emotion. That delusion was possible when I was young, healthy, and society was stable. But looking back, I realize society was seldom stable.

I have a hard time imagining how the young are reacting to the pandemic mentally and emotionally. Do their youth overpower their fears, or do their fears undermine their youth? I am too distant from them psychically to empathize. I assume it’s quite a trip being laid on them.

I live in the American South and all the reports tell us we’re next in line for major pandemic growth. Ignoring that is hard. The older I get the more I envy robots. Being a conscious mind on top of a soup of chemical and biological reactions is a razor’s edge of a tightrope to walk. The idea of just having discrete circuits and powerful fast emotion-free thinking is so damn appealing.

The reality is I’m not a robot, nor am I Yoda, and I’m definitely not a Zen Master, and all the wishing in the world won’t make it so. I also feel sorry for all the people who have faith in prayer or Donald Trump’s reality avoidance systems. Our emotions have a hard time when hard reality canes us viciously about the head and shoulders.

JWH

 

 

 

Playing Six Degrees of Separation with SARS-CoV-2

by James Wallace Harris, Sunday, March 22, 2020

This morning I got up and decided to think positive about our situation.  First, we have to consider the numbers. I like to use rules of thumb to make easy comparisons, so here’s a table based on a world population of 7 billion. (It’s really 7.7, but I’m making it easier on myself mathematically.)

Population Percent
7,000,000,000 100%
700,000,000 10%
70,000,000 1%
7,000,000 .1%
700,000 .01%
70,000 .001%
7,000 .0001%
700 .00001%
70 .000001%
7 .0000001%

I feel looking at the math should reduce our fears — at least for now. Using nCoV2019.live for my stats, worldwide there are 323,117 confirmed cases of SARS-CoV-2 this morning. That’s about .005% of the population. 13,848 have died, or about .0002%. Now, I no longer trust my math skills, but I believe that’s 1 in 505,488 for dying, and 1 in 21,664 for being infected. Those numbers make me feel better.

Of course, that’s using the total population of the world. If you live in Italy or New York City, your chances are much greater at being infected or dying. The U.S. has roughly 327 million citizens, meaning if we only consider it, which has 27,684 infected people with 354 deaths as of 3/22/20, then there’s a 1 in 11,812 chance of being infected, and 1 in 923,728 of dying. Still not bad. However, the population of NYC is 8,623,000, and if all 12,683 infected cases from New York state were in the city, that’s only 1 chance in 680. Now, they are starting to get scary.

Depending on where you live, you might feel your odds are pretty good.

During the initial stages of a worldwide pandemic, your chances of being infected increases by how many people you know who travel. Remember the Six Degrees of Separation game? Right now, most people outside of Wuhan who have caught SARS-CoV-2 were just one or two degrees away from meeting someone who recently flew. At first, it was people who traveled from China, but now it’s more about people coming from Seattle or New York City, but eventually, it will be about the people who drive around your city.

I don’t know anyone who has the disease. It takes One Degree of Separation to catch Covid-19. I don’t know how close the plague is, it could be two, three, or even four degrees away. Things will get much more frightening when we know people who know infected people — two degrees away. So far, I don’t know any two-degree people or even heard of any three-degree people.

The reason why China has been able to contain the disease is that it tracked every connection. The U.S. has allowed the disease to get out of control, which means they can’t track the various degrees of separation. However, by getting everyone to shelter in place they could get the pandemic under control again and then start tracing the infections.

Some states and smaller cities might be able to track all the cases of infection and keep things under control. But that won’t work unless people stop moving around. The reason why the game Six Degrees of Separation actually works is humans love to travel. It’s why the pandemic spread so quickly.

I wonder what we will learn from this lesson. When a pandemic breaks out, we should stop all air travel immediately. That means travelers will get stuck in foreign cities for the duration. We won’t know how far we’re willing to go until this pandemic is over and see its total cost. Besides killing a lot of people, it will probably devastate the world economies. That might make us savvier about the next time.

It’s been about a century since the last terrible pandemic. It would be comforting to think another horrible pandemic won’t come around for another century. However, humans are increasingly doing things to up our chances of another pandemic. We could be more careful if we wanted. It’s a matter of science, education, and statistics.

I wonder if this pandemic will teach us the value of science. Too many people dismiss science because it reveals unpleasant statistics. I found this cartoon on Facebook that should remind everyone of the true value of science. It got only one like by my friends when I reposted it.

science

JWH

 

Lessons From Black Swans

by James Wallace Harris, Wednesday, March 18, 2020

We always learn something from black swan events, such as the 9/11 attacks and the 2008 financial collapse. First, we’re always shocked by changes that many predicted and see the obvious warnings in hindsight. With the current pandemic, we’re now realizing just how many books and movies imagined an event like this one, and we asked ourselves “Why weren’t we prepared?” There were those who warned us about terrorist attacks and economic bubbles but we didn’t listen to them either.

Basically, people are hopeful. Or at least, they need to turn a blind eye to fear of the future. After the black swan lands, we become so fearful of another similar landing that we become paranoid for decades. We’ve spent trillions on worrying about terrorism since 9/11, and whenever Wall Street got the sniffles we’ve freaked out worrying about another giant economic downturn. Singapore was better prepared for COVID-19 because it had already experienced a SARS outbreak. We do learn, it just takes a big kick in the head first. On the other hand, some groups like Boomers and the Faithful are still living in denial about the current black swan. And preppers are having a big “I told you so” moment.

It now looks like this pandemic will hurt more Americans than terrorisms and wars, and damage the economy far more than any shenanigans of big business. We hope the coronavirus will clear up in weeks, but it could change the country for decades, just like other black swans. Events like this pandemic will also identify the grasshoppers and ants in society. Aesop’s fable told us not to always party and put away for tomorrow. This plague is going to sicken more people financially than medically. Far from everyone heeded the advice to set aside six months of living expenses, but really, how many ever imagined they would be told to stay home for months? I expect the lessons learned from surviving this pandemic will affect how people live for decades to come. And that too could affect the long term economic outlook. And I bet getting vaccinated for everything offered will become a lot more popular.

You’d think we’d start learning how to handle black swans. We’ve known for a very long time that if some people eat bats in China or monkeys in Africa diseases that previously only existed in animal reservoirs would jump the dam to dwell in us. We’ve had decades of experience containing these pathogen breakouts, knocking them back, and knowing if we failed the disease would become part of our regular lives. Every year cold and flu viruses flare up and travel around the world because so viruses are entrenched in us. If we don’t contain the coronavirus it could house itself permanently in Homo sapiens and either become an annual flareup or a chronic problem like TB. We don’t know enough yet, to say which.

For the year 2017, the CDC said these were the leading causes of deaths in the U.S.:

  • Heart disease: 647,457
  • Cancer: 599,108
  • Accidents (unintentional injuries): 169,936
  • Chronic lower respiratory diseases: 160,201
  • Stroke (cerebrovascular diseases): 146,383
  • Alzheimer’s disease: 121,404
  • Diabetes: 83,564
  • Influenza and Pneumonia: 55,672
  • Nephritis, nephrotic syndrome, and nephrosis: 50,633
  • Intentional self-harm (suicide): 47,173

If the coronavirus isn’t contained, and it looks like it won’t be, it could become another regular item on this list. The $64,000 question is where it will rank. Until we develop herd immunity and the experience of many years of living with mutated versions of the SARS/coronavirus, we won’t know. Eventually, it might become no more deadly than the other annual influenzas. But if it is truly ten times more deadly than the flu, it will come in at #3 behind heart disease and cancer. To handle that will require a complete transformation of our medical system. My guess is coronaviruses won’t be that deadly once humans develop natural and vaccinated immunities, but it will rank above Influenza and Pneumonia, or it will expand that category greatly.

What we have to do now is learn how to avoid COVID-19 until a vaccine can be developed. That means avoiding people for the next one to two years. I’m not sure we’re prepared to do that. But it also means learning to live in a new way — a much more germ conscious way. Should we allow so much airline travel if it confers such potential danger? So many economies depend on tourism. China has already announced bans on eating wild animals, but can they make hundreds of millions of people give up a multi-billion dollar industry that people have relished for centuries?

Can we invent personal bunny suits that protect us from diseases? Ones that are reusable, machine washable, and even fashionable? Can we invent vaccines that anticipate new diseases? Do we really need to congregate by the thousands? Will we just accept a certain level of death in society for the activities we love? We embrace cars knowing that 1.25 million people are killed by them every year — so maybe we’ll embrace gathering in sports arenas for ball games and rock concerts and just accept the related fatalities. Who knows what we will decide.

At first, I thought we were overreacting to the coronavirus. Everything is shutting down in my city which has only two infected people. I worried that thousands of people will be crushed financially. But the more I read about how European hospitals are being overrun by pandemic patients, and what it’s like to need a respirator to survive, that I now worry that we’re not panicking enough. I also assume if political leaders are freaked out enough to do all the things they are doing, then it’s probably going to be much worse than I feared. Political leaders aren’t known for quick action.

The die has been cast. Our society has committed to sheltering in place. Some people are thinking it will be for three weeks, but I don’t see how that’s possible. If the disease disappears with summer, I can see us getting a reprieve until next winter, but that means we need to hunker down for three months. Then we can run around for four months before taking shelter again. The goal is to wait it out until a vaccine is tested and distributed. Can we shelter in place for that long?

What if vaccines aren’t ready until Fall 2021? It means we have to learn a new way to live. How do we do our food shopping? How do people work and get paid? How do you go to the dentist or get your car repaired in the middle of a pandemic? If you need non-critical cataract or prostate surgery do you still go? It’s not going to be as bad as living through the Blitz in London or surviving Stalingrad, but it might be as challenging and inconvenient as living in America during WWII.

That’s the shocking thing about black swans — normalcy is suddenly disrupted — but we adapt. At least the people in history have. I’m already skilled at staying home for days at a time, so I don’t see learning to do it for weeks or months being a problem. But I do know most people might go crazy with cabin fever. And I worry about all my single friends. Sheltering at home for long periods by yourself might be deeply psychologically damaging. Many of my single friends also sneer at Facebook, but it might be a great social outlet during the plague months.

I’m lucky Susan moved back home last year after working a decade out of town. I’m also lucky that I have a wide-ranging set of internet friendships to keep me socially active. And I’m further lucky in that I have a long list of things I’ve been meaning to do. I generally ignore my to-do lists in favor of socializing, so maybe I’ll actually get some of the things done from those lists.

The most fascinating thing is we don’t know how this will change us. It’s another black swan about to land.

JWH