Saturday, February 26, 2011

What a gene wants, what a gene needs...


Cause and effect drives Western thought.  We look at things as a linear progression: A to B to C to D ad infinitum.  I am a direct result of physical forces that drove unicellular organisms to share responsibilities for survival a trillion or so years ago.  It is mechanical and objective.  I see what you see.  So what do we see?

There is a "force" that we seem to see when describing/understanding cause and effect: desire.  A gene "wants" to survive.  It wants immortality.  But really, a gene doesn't want shit.  A rock doesn't want to fall; ice doesn't want to expand; a tree doesn't want to grow.  A worm doesn't want to eat shit and, I'd even argue that a dog doesn't want to crap or fuck.  These things just do.  They just exist.

This puts us in a chicken or egg situation.  Do I act because of desire, or describe the already initiated act by desire?  There is some scientific evidence that it is the latter.  Our actions (at least a subset of actions studied) are initiated a fraction of a second prior to our conscious decision to perform them.  Whether this is true or not doesn't really matter.  It doesn't matter because I don't know where my desires are initiated anyway.  Why do I like the color blue?  Why do I love my wife and child?  Why do I brush my teeth?  To maintain their health.  Why do I want to maintain their health?  Cosmetic, practical, and customary reasons.  Why do I care about these things?  The pre-pubescent eternal questioning can go on forever.  (It's pre-pubescent because after puberty you only have one question: how do I get laid?)  At certain point, it just is.  I just like the color blue.  I just love my wife and child.  


Wednesday, February 23, 2011

Babies and Heroin

The long-awaited follow-up to "Babies and Suicide."  My baby-less friend and I had an interesting conversation regarding the irrationality of loving ones baby.  We "justify" our love for our babies on multiple levels: genetic progression and molecular immortality; provision of personal meaning and purpose; communal growth and sustainment; societal expectations; and so-fucking-cute-ness.  But the reality is, it is inexplicable.  It is irrational, incomprehensible, and indeterminable.  In other words it simply exists.  It is what it is and I can't rationalize it.  

Having a baby is a drug.  It stimulates some neuron in some minimally used portion of our brain that causes us to act like rats and push the reward button incessantly and at whatever cost.  Babies are heroin.  Just like no one can rationalize the heroin experience or why one would sacrifice everything for it, I can't rationalize my love for my baby or why I would sacrifice everything for her.  You don't know until you try.  The first one's free.  (That's actually not true.  My financial advisor told me to plan on saving $300K for college in 2027.  Not a good marketing scheme for the baby pushers.)

Procreation, individual genetic progression, and social evolution seem about as basic as things come.  The cause, effect, and meaning seem clear.  But they are not.  Again, I don't know why I love my child, I just do.  I can come up with a million reasons that seem rational, but none are perfect.  I rely on the poets and playwrights to explain it adequately.  If the supposed base of our entire being - procreation - is inexplicable without obvious causes and effects except those that describe the entity but not make its being apparent (i.e. I can give you a million reasons why I love my child but none are absolutely true; each is a brushstroke on Van Gogh's Starry Night, but I want the whole picture!), what else that seems obviously explicable is just the opposite?  


Thursday, February 17, 2011

Masturbation and time travel, or How can I possibly regret anything?

I have my childish fantasies.  One that crops up consistently is the back-in-time-change-things-for-the-better one where I find a wormhole at the bottom of my Corona that allows me to walk a bridge to my past.  Usually that bridge is to my college years.  I don't regret my college years at all.  I had a GREAT time.  The greatness, however, was transient.  I could have done things differently to allow for a longer, more steady influx of greatness.  The things that get me going now (knowledge acquisition and interpretation and Coronas) are not what got me going then (except the Coronas).  But since my daughter's birth, I always find a glitch in that fantasy.  I can't possibly go back in time because I didn't count how many times I masturbated.

Yes, time travel is an impossibility for me because of masturbation.

My daughter is by far and away the greatest thing that has ever happened to me.  I would not do anything to risk not having her.  I don't just want a daughter, I want my daughter.  What if I went back in time and masturbated one more or one less time?  Prospects of my daughter would go down the drain (literally).

I enjoy where I am.  I enjoy my life.  I have very few complaints and, in the end, feel very lucky to be me.  So how many other things in my life are so exquisitely dependent on little, seemingly meaningless aspects of my past?  How can I have regrets when I am happy to be where and who I am?


Tuesday, February 15, 2011

Complexity as a disease

I was thinking about chaos today.  Chaos theory, complexity theory, emergence theory, all that shit amounts to patterns within chaos (at least it does to those of us with brains incapable of accurate mathematics).  Things as we see them are not the sum of their parts.  I am not the sum of atoms and electrons and molecules and proteins and cells and organs and whatever.  I as an entity emerge from those things.

Complex entities have two important properties.  First, they are robust: they can handle a lot of shit (like the crazed, Kali wielding Scotsman of "Cats in a Sack") without apparent dysfunction.  The second property is called the tipping point: the complex system that hides the dysfunction from our eyes/ears/nose/throat/touch becomes saturated.  The dysfunction then becomes immediately apparent.

The key is things as we see them.  There is a lot of ego tied up in concepts of chaos.  I can't comprehend it, so it must be chaotic.  This of course is not the case.  The pattern is there from the beginning.  Our inability to perceive it is a function of our dysfunction: we lack the capability.  Chaos is inherent in us.  It is not external.  

The opposite is true as well.  Coherence is internal.  Patterns don't exist outside our consciousness.  Chaos and coherence are labels like dog, cat, human.  This makes it interesting.  Coherence is in our heads, but lack of coherence is a defect in our heads; it is a limit to our perception and understanding. Following this logic (if you can call it that), we can't figure out our own heads.  My mind labels certain systems as a pattern.  I "can't" label certain systems as a pattern, not because I can't "see" it, but because I can't create it.  This makes us entirely responsible for the coherence of our environment.  I am the master of my own chaos or the lack there of.  

Disease is chaos.  It has a million little pieces that, when confronting it personally and directly, are impossible to grasp.  As physicians, we eliminate the chaos by creating patterns: congestive heart failure, diabetes, arthritis, cancer.  These are all labels and patterns.  And they are created in our minds as physicians.  But the pattern you create as the patient may differ.  Regardless, I direct you through my system of patterns, my coherence.  I make it so you are no longer the master of your own chaos.  


Wednesday, February 9, 2011

Proposition 69: A Ban on Traditional Marriage

Here's my foray into politics: I would like to propose a ban on traditional marriage. I am worried that my next door neighbor's traditional marriage may negatively impact my daughter.  

What is it about traditional marriage that I find so dangerous?  It's not the white-washed, Zoloft-induced, fake-ass wifie's smile that hides all but the eyes which overlook the workaholic, nanny-fucking father; the Xanax-curbed, coke-bingeing, straight A daughter; and the pseudo-sexual, near suicidal, will never be Jesus son.  (I actually made that all up.  I really like my neighbors.  But I don't think I'd like them as much as I would enjoy the middle-aged Jersey-Shoreness that the neighbors I just made up would provide.  I'd save a lot on cable.)   What I find so dangerous in traditional marriage is the concept of marriage itself.  It becomes it's own entity.  An entity with defined parameters that require "work".  To be married means something (whatever that something is) whether you fit that meaning or not.  

Marriage should be seen as what it is: a personal and legal symbol.  Legally, it's easy: we're recognized by the state because we signed love-papers and therefore receive benefits.  Personally, it is not so easy.  The symbol needs to be individually and co-operatively designed, defined, refined, aligned, combined, and intertwined.  It is a beautiful and unmanageable product of the love between two people.  I was committed to my wife long before we had a paper-signing party (i.e. wedding day).  Getting married had two purposes: the legal recognition and the opportunity to bring everyone we loved together in the same room to celebrate us.

One could argue that we have a traditional marriage.  I am technically a man and my wife is technically a woman.  But on closer inspection, I'd say she has significant manliness and I have significant gay-li-ness.  In fact, the only differences between me and my gay friends are that I'm not sexually attracted to men and I dress poorly.  Otherwise I love the theater; have no problems talking about my feelings; tend towards the dramatic; and listen to Justin Timberlake, Rihanna, and Fergie (my gay friends would be appalled by the Fergie comment).  As for my wife, the only differences between her and a bulldog are that she sometimes wears lipstick; she's hot; she's intelligent; she's bipedal; she cleans up her own shit; she has normal human hygiene...I'll stop there.  It appears that unlike Sarah Palin, my wife differs significantly from a bulldog in all ways except her tenacity.  My point, however, is she's definitely an alpha male except without the maleness.  So how traditional is our marriage?  

To tell you the truth, I'm sick of people telling me what marriage should or should not be.  Whether you are talking about same-sex, different-sex, mutli-sex, or whatever-sex marriage, you are making a comment on my marriage too.  You suggest that the nature and purpose of my marriage is fulfilled because I have a penis and my partner has a vagina. You cannot reduce my love for my wife to easy fitting appendages.  In fact, if I were gay, I wouldn't want the love I have for my partner to be so narrowly defined as it seems to be when "married" (although I would get married - and divorced like 60% of "traditional" marriages - just to tell the man to fuck himself).  In fact, if I were not gay, I wouldn't want the love I have for my partner to be so narrowly defined as it seems to be when "married" (although I did get married for whatever ill-defined reason; therefore EVERYONE should be able to get married for whatever ill-defined reason even if it's just to tell the man to fuck himself).

So please, vote for Proposition 69 to ban traditional marriage.  From now on, marriage is what you and your partner make it.  Fuck everyone else.


Sunday, February 6, 2011

Taking my father for granted on Superbowl Sunday

My dad died in 1997. He loved football. Morning until night every Sunday. I wondered if he'd be watching the Packers beat the Steelers today if he were alive. Of course he would. And I would have flown out to watch it with him like I'd do every year if he were alive. Then I thought, no I wouldn't. If he were alive I'd see him once a year and talk to him once or twice a month. If my dad were alive, I'd take him entirely for granted.

I wish I could fly out to watch the Superbowl with my dad. I wish I did when I had the chance.


Anxiety is easier

I sleep fine.  It takes maybe ten or so minutes for me to fall asleep and I stay that way without effort.  My life, my imaginations, my cares are a comfort at bedtime.  They remind me I'm alive and that I'm going somewhere.

My wife can't sleep.  She hasn't been able to for decades.  Her mind comes alive at bed.  What's next?  What's now?  What has been?  How can you possibly sleep when there is so much?  So she paces; she cleans; she reads; she jots it all down.

My daughter is two years old and sleeps like a baby (coincidence?).  How will she sleep when she gets older?  Like her hibernating father or her persevering (to continue a course of action even in the face of difficulty) mother?  When I asked myself this question, the answer arrived instantly: her mother.  Anxiety is easier.  

I have no follow-up to this.  I am astounded and appalled but I am certain it is the truth.  Anxiety is easier for me as well.  I just have a talent for sleep.  I worry about a lot that my wife doesn't and vice versa.  To stop worrying is too stressful.  I don't know why this is the case. 

Fuck, I'm not going to sleep tonight.


Thursday, February 3, 2011

Fame monster

I had an interesting conversation with my wife regarding my writing. First, though, I have to show you how it started off. The following occurred after my wife couldn't wait 1.5 minutes for a movie preview:

Husband:  I need to send you to patience school with our daughter.
Wife:  I need to send you to how not to be a dick school.
Husband:  I wouldn't be such a dick if you weren't so impatient.
Wife:  I wouldn't be so impatient if you weren't such a dick.

Oh the joys of marriage.

The discussion about my writing revolved around this need for external recognition I seem to have.  I rarely write for myself.  It lacks satisfaction for me.  When we explored it further, I realized it wasn't so much personal recognition.  I would love to write a popular novel or play or movie (or blog!) under a pseudonym.  I wouldn't need the fame.  My ideas seem to need the fame though.  The unanswered question at the end of our discussion was, "why?"

It's obviously not personal fame.  And it's not an unrealistic belief that my ideas can change the world.  I think that it's a couple things.  First, it is solidarity.  If you're reading my writing, we are sharing an experience.  I am not alone (and neither are you).  It's also a solidarity in thought.  If you're reading this or my book or play or whatever, I presume you share the same idea (I don't mean agree with the idea, I simply mean that the idea means something to you whether negatively or positively).  

Secondly, it's an exploration.  My ideas are extremely important to me.  The reality of it is, however, these ideas are not clear to me.  I don't really know what I'm talking about until I'm halfway done writing it.  Even then it is very much in the abstract until someone else interprets it.  In essence, I understand my ideas and thus my mind through external interpretation.

I share this world with you, both in body and mind.  The body part is easy to understand, the mind not so much.  Writing helps me understand this.

If a tree falls in the woods and no one is there to hear it, does it make a sound?  If I write a blog and no one is there to read it, do I make sense?  


Wednesday, February 2, 2011

My future with Justin Timberlake

I'm a 36 year old anesthesiologist with a daughter, a wife, and a mortgage.  In high school, I prepared for college.  In college I prepared for med school, then residency, then fellowship, then the real world.  Now I'm here.

So what now?

There's nothing to strive towards other than the goals I set for myself.  I must admit, however, I am neither menacing nor a particularly good task master.  Why the hell should I listen to me?  Certainly I could write a novel, master Jujitsu, trek the Sahara, publish scientific and philosophical articles, climb mount whatever is the tallest.  Or I can veg out on the couch and watch Jersey Shore.  Who's going to stop me?  Me?  I weigh all of 145 pounds.  I could kick my ass!

I do have plans, however.  I want to be a writer.  Novels, plays, screenplays, and apparently blogs.  But let me tell you how I envision this goal: dancing with my wife to Justin Timberlake's SexyBack at an after-Oscar party sipping Cristal until 4 a.m.  (Realistically it would be a Corona and we'd be back by 11 using the babysitter as an excuse while hiding our obvious exhaustion from staying up past 10.)  That's my writing goal.

What I'm hoping to find out from you is that this is a normal goal for a 36 year old anesthesiologist with a daughter, a wife, and a mortgage.

Right?...
Hello?...
Bueller?...

Tuesday, February 1, 2011

Pity party for my inner hypochondriac

As with all psychopathologies, it is best to place the blame on one's parents.  My father had significant cardiac disease with a heart attack at 38 and 40 and sudden cardiac death at 57.  Since I became a physician, I retrospectively diagnosed him with obstructive sleep apnea, peripheral vascular disease, and metabolic syndrome.  He wasn't on a statin or an aspirin, and he was on an anti-arrythmic that causes sudden death.  In other words, there are six things off the top of my head that could have been done.  (could have done?  Guilt is our most constant companion.)  Moreover, he ate like shit, smoked, drank too much, and barely got off the couch.  (As an aside, this isn't to berate my dad.  He was a remarkeable man.  He was the most insightful and intelligent person I have ever met and treated me with the utmost love and respect.  He just didn't treat himself with love and respect.)  His disease, although mixed with genetics and bad luck, was mainly due to a lack of action: not taking the proper meds; not exercising; not eating well; not receiving the proper diagnosis; not getting surgery; etc.

So I take action.  I eat (sorta) well; I exercise; and I take a statin and aspirin.  The problem I have is my near obsession with action.  My hypochondria clusters (and they do come in clusters depending on what is occurring in other aspects of my life) are less about the disease process and more about what I have to do about it.  Go to the doctor; make sure s/he does the correct tests; wait it out; not wait it out.  The possibilities are endless.  I start to malfunction because I am convinced there is something that I am not doing.  I often think that it would be easier to live during a time when there was very little we could do with illness (assuming that there was minimal diagnosing; it's worse to have a disease with a name but no treatment).

The problem is, when you look closely at it, there is no "correct" thing to do.  It's all probability.  I am not trying to imply that there is no such thing as preventative medicine.  My grandma lived to 88 as a lifetime smoker, but for everyone like her, I can find 100 smokers that died of a heart attack, emphysema, stroke, or cancer.  Taking control of my eating and exercise simply gives me the illusion that I have control over the possibility of future heart disease.  It certainly puts the odds in my favor, but it is not control.  I have no control over any future disease state.  This is truly an existential dilemma: I have control over what I do now (i.e. not smoke or eat like shit) but have no control over the future (i.e. heart disease or lack of it) despite the fact that I put an enormous amount of thought and meaning into it.

When faced with our mortality, it again comes down to the ability to surrender to the present.  I (we?) need to reposition the meaning and magnitude of our existence within that existence and not in what may be.