Cancer 13
Posted on February 23, 2023 1 Comment
Notions of god have never played an important part in my life. Having a life challenging experience such as the one I am currently going through has made no difference whatsoever to my views. As I have said in an earlier post; you don’t exist, you exist, you don’t exist. That’s it.
I have my narrative of the rejection of Christianity, with its two critical elements, crying so much at the age of 3 that I had to be taken out of church, and walking to school down the croft (a field on the way to school, now covered with houses, some of which I helped build in a previous career) at the age of 7 and suddenly realising, once and for all that there is no god, that it is just a made up story.
My reasoning may have become a little more sophisticated since then, but I have never doubted my atheism. I have never been to another church service apart from weddings, funerals and the like since that day when I was 3. I don’t like churches. I find them unpleasant. They smell with a lingering sense of the obscenity of faith, despair and hopelessness. After all, what hope of life is there for a person who simply looks forward to paradise after death? Live now as there is no tomorrow.
Many philosophers have made their name through discussion of the possible existence and nature of god. Descartes, in his Meditations, argued for a system of doubt as a means of understanding the world. He progressively doubted (nearly) everything, arguing thathe could not be sure of the existence of an external world as his senses might be deceiving him. In the end he doubted everything except the existence of god, and through this rebuilt the world as he assumed that a kind and loving god would not deceive him about the world, so therefore it really existed. Descartes’ method of doubt is sensible, until he found he could not doubt god, and then it falls to pieces. For the system to work he had to doubt everything, including god, but if he doubted god he was left with nothing. He would then have to build up the world through evidence. He would probably learn to trust his senses and realise that the world existed, other people existed, but he would find that there is no reason to not doubt god’s existence, so he would have to conclude that god does not exist – which did not fit his world view.
If you really want a god then you could try Spinoza’s god. Spinoza argued that the universe consists of only one substance, an infinite substance, that he called both god and nature. These terms are interchangeable, so god is nature and nature is god. The problem with this is why both with god? There is one substance, nature, so why give it another name, god? Pretty pointless really.
It was the Enlightenment that saw the separation of god and philosophy, with the latter based on reason and the former on faith. Kant argued that while we cannot prove the existence of god with empirical knowledge we cannot prove his non-existence. Fair enough, but then why bother with the concept of god if it stands outside our ways of thinking? Nietsche did not actually say god is dead, but he rejected belief in god as unrealistic, weak and untenable. God had never lived so how could he die? For Nietsche, god is irrelevant. For Freud, god is a projection of the mind, a kind of wish fulfilment. I like this idea, that of god as being an extension of the self, basically a weak form of mental illness where people refuse to take personal responsibility for their actions, ‘It wasn’t me it was the extension of my self that is god.’
In our modern world we are told to have respect for the various religions. I am unable to do so, basically because religions are silly and childish. I can respect the person but not their religion. Religions are the cause of so much of the harm in the world. I work in science. I do not see how someone who genuinely believes there is some sort of bearded fairy in the sky who created us all out of magical clay can be a real scientist. That is back to Descartes’ failure to doubt the existence of god. We are trained to be skeptical, to disbelieve, to argue against matters of faith and present evidence for the structure of the world and our understanding of the way it works. We have a fair understanding of many aspects of the universe, though there is still a lot to learn, and we have become much better at engineering the world to make it a better place to live. We have made plenty of mistakes, but if we are to advance our knowledge and make life better (whatever that is) we are going to make mistakes. Some bridges fall down, but most enable us to cross from one point to another in safety.
With regard to my cancer I prefer to put myself in the hands of trained and competent scientific medical practitioners who have a good understanding of the nature of cancer and how it can be treated than the imaginary bearded blunder that many people think is responsible for the world. If my treatment goes badly wrong then I die, which I will do anyway in the next few decades. If, as is much more likely based on the science, it works, then I get to live for a while longer. When I do die, whether it is sooner or later, I will cease to exist. As Bertrand Russell said regarding death, ‘I should scorn to shiver with terror at the thought of annihilation.’
Cancer 8
Posted on February 22, 2023 2 Comments
Sometimes it is overwhelming. It is difficult to describe in words. It can reach a point where I feel I cannot cope, I cannot cope with my cancer, my sister’s cancer (she is in the final stage of life) and my heart failure, let alone the everyday stressors of life; yet I have to cope, There really is no alternative. Breaking down is not an option. Fortunately these feelings do not usually last long. Within hours I generally restore that unmoving lip.
Human resilience is incredible. Both the psychology profession and society general tend to focus on the negative: so many people have mental health problems, how we all need counselling or psychotherapy when something horrid or stressful happens, how we can’t cope with death and serious illness, how watching something on the TV can be traumatic (!). The reality is that most of us cope very well. I have spoken in a previous blog about social support, but I think we as individuals are – usually – incredibly strong and able to deal with most of what is thrown at us in life.
I realise that many people have genuine problems, and that some are unable to cope and do need professional help, but I am focussing on that large majority of us who usually deal with things pretty well.
In society we seem to have a problem with negative feelings and emotions. We want to be happy at all times. If we are a little sad we call it depression, label it as a mental health problem, and swallow pills or talk to psychologists and counsellors. Instead, much of the time, we should just realise that life is not just about happiness, it is about the whole range of emotions. We all experience death. We all experience illness. We all experience very stressful times in life. It may sound old-fashioned but I often want to say get a grip. You can cope. These things are normal. If someone dies we are sad, often very sad, but we eventually get over it and start living normally again. We grow to remember the dead person with fondness (or not!), and get on with life. We reflect back, remember, get sad, have a few tears, but these are moments. They should not take over our lives.
One area of my research is post-traumatic stress disorder (PTSD). I became interested when I was working with World War Two veterans. I found that there were some who had very serious problems relating to their war experience, and could suitably be classified as having PTSD. They experienced traumatic events, and they had difficulty dealing with those events. Memories would emerge at various points in life and cause serious problems that sometimes needed professional help. The problem now is that the word trauma is overused. Everything negative is traumatic. My dog died, how traumatic. I saw something upsetting on TV. How traumatic. I had an argument with my wife. How traumatic.
None of these things are traumatic. They can be genuinely upsetting but they do not constitute a mental health problem.
We have a large and growing language about the negative aspects of life. We should spend more time talking about the positive aspects of life. Some psychologists do discuss the positive aspects of life, but they are relatively rare. Most of us, and I am guilty of this, focus on the negative, while trying to make things a little better. It is laudable, particularly when someone has a serious problem that really does need the help of a psychologist, but it is often the case that people need to recognise that there are bad bits in life and deal with them.
It is often about the way we appraise our situation. Shit happens. Right, how are we going to deal with this? Deal with it and get over it. Having moments of feeling unable to cope does not mean I have a mental health problem.
Cancer 7
Posted on February 20, 2023 Leave a Comment
I have a date for my operation, Wednesday 15 March. Beware the Ides of March. Apparently this is the day in the Roman calendar when debts were settled. It was the date Julius Caesar (the real one, not just the one in Shakespeare’s play) was killed. He was stabbed by a number of senators, so I hope that the surgeon isn’t wearing a toga and that his knife is a scalpel rather than a dagger! I know, I have an ego problem, comparing myself to Julius Caesar. Anyway, back to the story.
One of the main complications with my cancer is that I also have heart failure and atrial fibrillation. It is probably rather careless to have two of the biggest killers in Western society at the same time, but hey, what’s the point of moderation?
It is a challenge to defeat them both, as I hope to do so for at least for the next 20 or 30 years. I have lived with heart failure for the last three years, taking a cocktail of drugs morning and night.
Furosemide is a diuretic which helps to reduce the build up of fluid in the body. It is meant to make someone want to urinate after about 30 minutes and then again after about two hours. Having a man-bladder, I tend to go about every 10-15 minutes for a couple of hours. I know every stopping point by the side of the road for a 30 mile radius.
Ramipril is used to treat high blood pressure by widening the blood vessels, making it easier for the heart to pump blood around the body, though since I have had heart failure I don’t seem to have any blood. Whenever someone wants to take a sample they end up poking the needle around in my empty arm for ages.
Rivaroxaban is an anticoagulant. People with an irregular heartbeat are more likely to experience a blood clot. It is also used after operations, so that could come in handy soon. It does make people bleed more easily, which is partly why I was not initially worried about blood in my stools.
Bisoprolol is a beta blocker used to treat high blood pressure and atrial fibrillation. It slows the heart rate.
At first my heart failure severely restricted my ability to do anything, but once I had a cardioversion I could get on and do most things. The cardioversion is used to treat atrial fibrillation. Basically, it is a large electric shock that stops the heart and restarts it again in rhythm. It is a bit like turning your computer off and on again to make it work properly. It is done under general anaesthetic. At first I thought I could do it under a local but then I saw a video. The procedure is that you are strapped onto a bed, cushioned at both sides. large electrodes are attached to your back and front, and then several thousand volts are pumped through your body. Seeing the response of a person to the shock is what made me accept the general anaestheic.
Cardioversion does not always work, and when it does work it can be temporary. I had mine two and a half years ago and my heart is still in rhythm. One worry I have now is that the cancer operation may mean my heart reverts to arrythmia . We will see.
Heart failure does change your life. Apart from trying to remember to take the drugs twice a day I am restricted in how far I can walk, and how long I can do any kind of physical exercise. It is an odd feeling. I do, say, gardening or walking for an hour and that is it, I suddenly can’t do any more. It is not because I feel exhausted or my limbs ache, I just cease to function, so I have to sit down and that is it for the day. I also get very tired at night, but whereas Cinderella could keep going until midnight, I fade by 9pm.
Sometimes I wonder about havng the stength to deal with these two diseases, but in the end there is no choice. Get on with it or disappear into depression. Depression certainly won’t help with my treatment so it is important to follow the wartime statement, now sadly abused by endless posters and word changes, but still powerful in its original form: ‘Keep calm and carry on’.
Cancer 6
Posted on February 17, 2023 Leave a Comment
Perhaps the best thing to come out of having a diagnosis of cancer is the support I have received from so many people. There are messages on social media, and many more personal messages. There are messages from friends and family, and from people I know less well and some from people I don’t know at all. They have been universally positive (including my favourite: ‘Excellent writing, you should get fatal diseases more often’), and just go to show that there is humanity in humanity, that despite all the awfulness going round (whether it is Ukraine or Brexit) people are – as Rousseau would have it – generally good.
Rousseau focused his arguments at the level of society rather than individual interactions, but he recognised that people are dependent on one another. He thought that this dependence was often problematic because in part we derive our sense of self from others and that this can be a negative restriction of individual freedom. I would disagree. That part of us the derives from others, from the behaviour of others, is crucially important. Alone we are nothing, we need others to be fulfilled. This doesn’t restrict freedom, it enhances it. One element of this need we all have for others, this gemeinschaft, is what in psychology we crudely call social support.
The following definition of social support is from the American Psychological Association: “The provision of assistance or comfort to others, typically to help them cope with biological, psychological, and social stressors. Support may arise from any interpersonal relationship in an individual’s social network, involving family members, friends, neighbors, religious institutions, colleagues, caregivers, or support groups. It may take the form of practical help (e.g., doing chores, offering advice), tangible support that involves giving money or other direct material assistance, and emotional support that allows the individual to feel valued, accepted, and understood.”
Another way of looking at the need for others is reflected in the book I am writing at the moment, which is about narrative psychology. There are chapters on the levels of narrative that we use, from personal narratives regarding how we think about ourselves to the master narratives that apply across all or most of the people in society, from driving on a particular side of the road to the words and phrases used in greeting. This is relevant to support because it shows that no matter what Margaret Thatcher claimed, there is such a thing as society. Society is a group of interdependent people who cannot fully function if they are isolated. If one person has a problem, others naturally want to help.
And it is a great help, knowing that people are thinking about you. My prognosis at the moment is looking more positive than it did (at least to me) a few days ago, but it still malignant cancer, the treatment will probably take most of this year (bye bye summer holiday) and it will now live with me forever even if I am officially declared clear, so folks, I will be depending on your continued support until the day I die!
It is not only that people are declaring their support, but they are declaring their willingness to help, and they are actually helping. It does leave me free to deal with both the practicalities that I have to deal with and my emotional state which, I must admit, does occasionally vary from the stiff upper lip approach that I like to retain both inwardly and outwardly.
Cancer 5
Posted on February 15, 2023 1 Comment
While most of the time I can get on with living reasonably normally there are moments, minutes, that are difficult. I lie awake at night, but I have always done that so that is no different really.
I have just spoken on the telephone with a nurse about my pre-op. I now have a date for it, so again it is becoming more real. My insides are all churned up, an area encompassing my heart, lungs, stomach, etc feel heavy. The neurotic inside me is alive and well, making me feel unwell. I know this feeling will go away in the next minutes, but at the moment I am sitting in a cafe writing this with my phone and my new folding keyboard, looking at the people around me who are living their normal lives, unaware there is a cancer in the room.
OK, I realise there may be other people in the room who have cancer, or people who know people who have cancer. I realise everyone has their own interesting or less interesting life stories, but cancer makes your own story somehow more important than others, it provides a focus around your own life. I see the woman at the next table fanning herself, probably going through the menopause. There is a family of four at another table. They look a bit hippyish and the parents probably treat the children a little too much like adults. There are older couples sitting drinking tea and eating soup, who presumably have been through everything life can throw at them – but today, now, with my churning stomach, I am the centre of things.
I would rather not be.
Dr Nigel Hunt 