Thoughts on neuropathy and touch – Infusion 9/12

Dear Friends,

Summary

Once again, I apologize for not being consistent in producing these occasional essays. I’ve just completed my 8th cycle of chemotherapy. As I write this, I’m in the Clinic undergoing my 9th cycle. This means there are only 3 cycles left!

Maybe I’d forgotten that my caregivers had been instructing me that during this process the chemo would gradually accumulate in my body, the poisons (er, medications) gaining in strength as that happened. As this took place, they warned me, my side effects would intensify. That is precisely what happened after cycle 8, two weeks ago. After this 8th infusion, all my previous symptoms heightened (neuropathy, nausea, drippy nose[1], fatigue [better described, in my case, as apathy or ennui], etc.) Despite my best “intellectual” intentions, my body and mind rejected anything I determined to accomplished that smacked of mental (to say nothing of physical exertion).  My mind’s compelling response was a puerile (I somewhat regrettably observe from this that childishness may never be completely erased, in even an adult male.) “Nah. Not now. Who cares? Watch some mind-numbing TV. Take a nap.  You can do all you want, tomorrow.” And so the week sped by without my posting a single blog update.

I’ve been jotting notes on selected Christmas cards Monica has addressed for us, confiding that–uncomfortable and annoying as the side effects may be–I recognize them to be predicted, within tolerable ranges, and by-products, merely, of what is healing me. Hence, I can easily put up with such incidental by-products while I slowly glean meaning and lessons from this process of illness, vulnerability, care-giving, care-receiving, healing… from the entire rich and related process.

I am similarly consoled to be able to turn over the monitoring of the intensity and the assessment of potential dangers of my side effects to my nurses and doctors, who have far more experience than I, in comparative patient reactions. So I find myself completely at ease with where I am, with respect to my annoying but not unmanageable discomforts and the timeline of treatment.

That said, I’m saddened (but gratefully aware of the reasons) to find that especially the women in my family (particularly Monica; Krysia; in her way, Anastasia; and my sister, Wandzia), find distressing, my apparent weakness and discomfort. They would rather not have me go through this unavoidable phase. It’s easier, by far, for me to come to terms with what I am experiencing, than it is for them to accept what they observe. I’d react in exactly the same way if our roles were reversed. Different experiences of the same illness. Evidence of the often under-recognized wider impact of illness: wider effects than can be observed in one patient, alone.

Detail

I’ve been thinking about nerves (i.e. neuropathy).

Pensée, the First

Think about one single nerve, whose one end terminates in the tip of your index finger. Perhaps this nerve is dedicated to recognizing temperature. It possesses some sort of knowledge about an acceptable temperature range for human beings. Or, more likely, any particular nerve is far “dumber.” It simply passes on observed information having to do with temperature. Elsewhere, that information might be interpreted to be within or outside an acceptable range. This particular nerve is essential to the time-honored tale of the toddler learning not to touch the burning oven or fireplace. Perhaps there is nowhere (even in our mind) that some pre-determined “temperate range” exists, prior to the experience of pain that can be registered by this nerve. This nerve, while specialized to deal with temperature, might merely (and in common with other nerves) register comfort or discomfort. Over the course of time, some operation of the mind might accumulate the massive amount of data continuously transmitted by this single nerve about the status of its specialization. Then the mind might begin to filter away those communications that are benign and ignorable. In this way, the mind might eliminate large amounts of incoming information that doesn’t need to be processed because experience shows that it can be ignored. At the same time the procedure heightens responsiveness to messages from the nerve that fall outside the ignorable range. “Ouch. This stovetop hurts me!”

My goal, here, is not to try to define “message”, “mind”, “information”, “knowledge”, or any of the other words I’ve conveniently (but not in any precise way) used, above. My goal is even less to attempt to describe the mechanism by which nerves “communicate”, “learn”, “process” or (importantly) “forget” what they register. It is enough, in this crude simplistic explanation, that I recognize, dimly, how many details exist, and how careful must be the intellectual and scientific work to describe and understand this process, even down to its chemical, molecular and electrical/energetic functional mechanisms. But all these are undeniably exciting, in themselves, as fields of attention.

Instead, my goal is to isolate this particular,—minute—nerve, on my index finger, to recognize two following facts that can be deduced (and verified by scientific investigation and experimentation).

(1) There must by multiple and countless “siblings” or “independent clones” of this single nerve. I know this because—even confined to my index finger—discovering that the stovetop is too hot for me to touch can be learned at various spots along my finger, and even at different points on the tip of my finger. One fixed nerve-ending couldn’t suffice. I’d have to be endowed with duplicate nerve endings at the top and sides of my fingertip, and more—closely-spaced—along the length and circumference and plane of my finger’s skin surface. Mind-boggling.

(2) If the nerve I’ve been describing is specialized for temperature, there must exist similar nerves, of a similar kind, specialized for other sensations (roughness/smoothness, pressure [very light to very strong…probably differentiated], movement/stasis, weight, thickness [in conjunction with other nerves], texture, density [solid or liquid], viscosity, stickiness…). The list is seemingly endless.

Its, perhaps, easy to see where I’m heading. I want to be aware of the incredible density of sensory apparatus nature has concentrated on my index finger. Aware of it, I can extrapolate that density to my remaining fingers; then to my hands; and thence to the rest of my body. I have an impression (and don’t wish to digress by trying to verify it) that the nerves I’m thinking about are not evenly distributed throughout my skin. My ankles—though evidently sensitive (in addition to appearing attractively svelte, these days)—seem to me not to have a comparable concentration of the same nerves as I’ve become aware of in my fingers.

Pensée, the Second

How interesting that…

  • I experience a distinct feeling of calming when my nurse puts her hand on my chest in order to stabilize it while she inserts a needle into my port.
  • in the West, we customary shake hands in greeting, instinctively affirming the potential, or reaffirming an existing relationship.
  • experimental studies have confirmed that the absense of touch in young mammals and human children cause substantial degradation of later confidence, happiness, and feelings of security.
  • liturgical ceremonies from the consecration of priests and bishops, to ritual confirmations of kings and emperors have historically, down to the present, included what is called “the laying on of hands.”
  • during the imposition of the Sacrament of the Sick (which I’ve been priviledged to receive), there is a similar laying on of hands. It conveys a distinct calm and brings peace.
  • holding hands is sought after by young lovers. When I hold hands with Monica it is a wonderfully brightening, loving, and consoling (not to mention exciting) experience.
  • we instinctively stroke the faces and bodies of those who are in pain.
  • we humans tend to want to cuddle… bringing the sensory apparatus of one being in close proximity with that of another.
  • we can share this intimacy, or this yearning to communicate, with other sentient human beings; not only human, but other species who co-exist with us on this earth.

I believe there is a good deal to wonder at, in the awareness of the density of sensory apparatus that is part of our corporeal selves. Clearly, many of the apparati exist to make us aware of danger and protect us against a potentially hostile external world. But many more seem to exist to pass messages among us that are even more communicative (think broadband, for you techies) than our uttered language.

With these thoughts, then, it seems appropriate to wish that during the forthcomingh holiday season, you be touched by and touch with great awareness, the people who surround you, nurture you, and live their lives with you. May you, too, be warmed by the Spirit who fills these festive days with meaning.

Chet

 

Notes

[1] Verification needed… I can’t tell if its a “medical urban myth” or has any basis in reality. I’ve not (yet) lost my hair, but my eyes (and especially my nose) seems to drip constantly and voluminously. I asked someone what causes this to happen, especially by my annoyingly constantly-dripping nose. They answered that—despite the fact I’d not lost the hair on my head or chin—I’d lost the hairs in my nose. Among their jobs was to keep my nose from running.  I find this—for some quirky reason—immensely amusing. But I’m also skeptical. Any feedback would be welcome at grycz@well.com . Merry Christmas!