Everyone is fighting all the time We the United States are number one in fighting and being assholes We fight with our allies, with our enemies, with countries that never imagined we would want to annex them
This is a symptom this is the dark underside of individualism of the very very strong male who leads with testosterone dick first
This is a symptom of fear. Under all the posturing the bravado, the yelling and accusations lies fear. Deep deep fear down to to the deepest trench in the ocean
This is a symptom of fear. Fear that stretches out into the universe, as big as the universe, fear of what?
Fear of Covid-19 of infection, of death.
Aren't we over that? No. We are still very very frightened, our adrenaline is up, our cortisol is up, our thyroid is down, and our sex hormones are down.
We are still very very frightened, wired all the time get infections more often tired from low thyroid and we don't or can't do sex.
We barely remember the influenza that swept the world 1918 to 1921 bodies stacked 5 deep under sheets in the hallways of hospitals in San Francisco
A Pacific Island lost 80% of the adults to death
We are fighting fear fighting each other fighting ourselves rattling our sabres shouting insults
Once again here I go out on a limb. Here is my prediction for the next Really Big Thing in medicine, which is already happening. It is slowly rising from the murky swampy depths of our unconscious.
Autoimmune encephalitis? Or encephalopathy? What a mouthful. And what the hell?
Well, we have always said that we do not know the causes of depression, mania, schizophrenia, psychosis and all the other psychiatric diagnoses.
And now I think we know, though we don’t have them all sorted yet.
The cause is the immune system. And what’s more, it’s adaptive.
“NO!” (you run screaming from the room). “Not MY immune system! NO!”
Yes, I say, your immune system, my immune system, everybody’s immune system.
WHY? Well, my version shuts me down. I get tachycardia (a fast heart rate), short of breath, accusations that I am manic, my fast twitch muscles don’t work and I get pneumonia. And it lasts longer each time. Two months. Two months. Six months. A year and a half on oxygen and then off but really it took four years before my muscles started working right again. It shuts down my fast twitch muscles but not my slow twitch muscles.
So how is shutting me down adaptive?
Think. If there is a pandemic, or huge danger, or someone is trying to harm me, it isolates me. People think I am very very weird when it is happening. So I isolate, to protect myself. Isolate and voila — protection from pandemic. If I have resources, and luckily I do have resources, I can hole up. Food, drink and a broadband connection.
The book Brain on Fire and movie are about an encephalopathy: antibodies to NMDR that made the author psychotic until it was recognized and treated. I went to a virtual continuing medical education on encephalopathy in 2022, I think. In the US alone, there were already 555 patients identified with NMDR antibodies.
Now there is a whole list of antibody encephalopathies, many associated with cancers. Not all.
A physician friend calls me a few years ago. “Have you heard of NMDR antibody disorder?”
“Yes,” I say
“I have a patient with it,” she says. We are a county of 32,000 people. Rural. She is looking it up. I tell her what I know.
In January I see a patient who turns out to have Anti-Caspr2. I have to look it up. Now I see the list of encephalopathies that is rapidly becoming longer and longer.
I think that chronic fatigue, fibromyalgia and long Covid fall into immune system disorders too. Just because we haven’t figured out the mechanism: well, we may. If we don’t destroy the planet first.
I also have reservations about treatment. We are using more and more immune suppressants. I read about one that stops B cells from working. Specifically, the B cells that produce antibodies. Well, that would work for my disorder, except, I already get pneumonia really easily. And destroying the B cells lowers immunity and increases the risk of infection.
I see a patient in clinic who has a skin infection and a fever and an autoimmune disease. They are on an immunosurpressant that I don’t know much about. “Have you called your rheumatologist?”
“No, why?”
“I think you are supposed to stop the immunosupressant. Please call them today. And let me know what they say. Please!” I start antibiotics.
The patient sends a MyChart message. Yes, stop the immunosupressant while on antibiotics. In the future they will call the rheumatology office as well as seeing the clinic for any infection.
I am not saying we shouldn’t use immunosupressants. Sometimes we have to. Rheumatoid arthritis. Hypothyroidism, the most common autoimmune disease, yes, we should and do give outside thyroid hormone. But there is something else we need to do.
The clues for this lie with chronic fatigue and fibromyalgia. What triggers them? One in ten severe infections, severe stress, or a combination.
So we need to learn as a culture, as a world, as humanity, to lower stress. We can’t be high sympathetic nervous system fight or flight high achieving high spending higher faster crazier all the time.
Here is to the parasympathetic state. That is where we need to go. Go down, slow down, be kind to each other and ourselves, be gentle, laugh, fail, lie in a hammock, watch silly cat videos and fat bear week. Then the immune system might calm down and not attack us to save us. I think the immune system is pretty smart, really. Even as it pisses me off and limits me.
Beloved
I don’t think I can bear this
It’s a good plan
To work five more years
And retire in better financial shape
House paid off
But it hurts so
My tattered bruised and battered heart
Already patched so many times
And to see so many people each day
Hurting
Why, Beloved?
Why don’t we mature?
Maybe I’ll be a tree again
Living wood
That bends and moves with the wind
That eats the sunlight
Drinks the rain
Endures the snow and drinks it as it melts
Until spring comes
And I stir and start to bud
Deciding when it’s time
To uncurl leaves in warm sun
_______________________
For the Ragtag Daily Prompt illusion. Or should it be delusion? Or survival? Or beyond that to peace?
Beloved why? I am glad for your love and warmth and connection and my cat’s and my adult children friends family patients work and why? Beloved
A high Adverse Childhood Experience Score Two alcoholic parents One sick with tuberculosis through pregnancy Letters from the hospital to her mother After birth Never mention me As if I do not exist
She told a story that she dreamed she gave birth to kittens played with them and gave them away
Not a dream of joyously welcoming her new baby
Me. Yet I didn’t hate her or my father My damaged parents My damaged sister Who followed their path, not mine There was nothing I could do Only three years old when she was born Try to shield and mother her As best I could
Why Beloved I have tried so hard to grow to love to forgive and yet I have no human lover
My cat jumps on my notebook And interrupts this writing She is happier to welcome me home Than any man I’ve ever dated
My daughter’s boyfriend picks her up at the airport and has made her dinner
If I am a failure at love with a partner Or too smart or damaged or difficult To love For humans At least my children have both found love And if I were to choose me or them Yes, I’d choose them
Is that why, Beloved? Sacrifice to heal the next generation? It is worth it.
And yet, that small child part of me That even as a toddler thought the adults were unpredictable, dangerous, mean when drunk as they laughed. She is angry at them, Beloved She is angry at you, Beloved Or at people Or at the universe She still believes in every cell, in her bone marrow, in the vast universe in her mind
I dream that my sister has drowned in the ocean. A sailboat went down. There were others on board. Two friends ready me to dive and find her. I don’t want to scuba dive, I am not trained. I don’t know how to use the equipment. I am afraid I will drown too. I see her daughter, who is four. Her daughter knows from my face that her mother is lost. My friends say, “You will be able to find her. You can find your sister.” “But she is dead,” I say. “I don’t want to find her.” I know that they are right, I could find her. But I might be separated and lost, in the depths. I don’t want to die too.
I wake up. The dream sticks. My friends wanting me to wear a borrowed wetsuit and scuba gear and go down untrained. My sister floating in the depths, dead eyes open. But she has been dead for years, I think. And this is the sea of dreams my unconscious the greater unconscious everything. So why isn’t my sister’s body dissolving? Changing to a skeleton. A skeleton coming apart over the years.
I don’t need a wetsuit or scuba gear to dive in the sea of dreams I can breathe in the unconscious I have been to the bottom of the sea many times before.
My niece is four in the dream. She was thirteen when her mother died. I think she was lost to me long before that. The dream knows. Her mother was lost to me when my niece was four. Drowned.
When the dream returns I will say yes to the dive I love the sea and the ocean and going deep I don’t need a wetsuit I don’t need scuba gear I don’t need to find my sister’s body She is gone Dissolved I let my past go.
I have not dreamed of the ocean
since.
__________________________________
I really don’t know where my sister is, because of the family schism after she died. Are her ashes somewhere?
my heart is broken
love doesn’t conquer all
unselfish love
unreturned
unrequited
opens me to wound after wound
some turn from love no matter what
cling to the lies they tell themselves
cling to the poison they embrace
turn from love into the uncaring bottle
turn from love into the insensate smoke
turn from love even to the grave
I wish my heart would let them go
and heal
__________________
My friend Liz took the photograph, half way through the Rainshadow Chorale concert last Sunday.
Is it ok for me to be a bit lazy?
A bit unkempt?
Not care about dandelions?
Weigh more?
Want to lie around after lunch?
Maybe there is something I should be doing
Maybe there isn’t something I should be doing Maybe I should be gazing at the navel of the universe Maybe I should be gazing at the navel of the Beloved Maybe I should not be doing all the time Maybe I should wait Maybe I should watch Maybe I should appreciate Being here
I remember. You are gone and dead I lie on my side, close my eyes I feel your body behind mine your arm tucked under me your breath on my hair your body warmth against me your arm lying across my side thighs and knees relaxed against mine you are not gone and dead as long as I can remember
Beloved, what is my path?
I remember. A path alone so that I can see so that I can hear so that I can feel so that I can write Beloved, you set the path before me a brief elaboration of a tube Beloved, sometimes I want Beloved, sometimes I say why Beloved, sometimes I forget
Discover and re-discover Mexicoβs cuisine, culture and history through the recipes, backyard stories and other interesting findings of an expatriate in Canada
Engaging in some lyrical athletics whilst painting pictures with words and pounding the pavement. I run; blog; write poetry; chase after my kids & drink coffee.
Refugees welcome - FlΓΌchtlinge willkommen I am teaching German to refugees. Ich unterrichte geflΓΌchtete Menschen in der deutschen Sprache. I am writing this blog in English and German because my friends speak English and German. Ich schreibe auf Deutsch und Englisch, weil meine Freunde Deutsch und Englisch sprechen.
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