Don't think about it.

Think about it: "it" being anything.

Think about it because you have to.

Consciousness has to be about something.  It always has a direction.  Consciousness cannot exist on its own.  Consciousness is a relationship, not an entity.

Think about it.

Because you have to.

So how does this effect experience?  Dismissing the infinite reduction of defining consciousness of something as an experience in itself (are you conscious of the conscious experience of that something?  are you conscious of that consciousness too?), we see that consciousness is the antithesis of experience.  The necessity of being about something requires consciousness to be dependent on time and perception (intangible ideas are also perceived).  Experience or being or existing is an absence of time.  It is an infinitesimal pinpoint of pre-reflection.  Perception, and thus consciousness, is reflective: you are always a nanosecond behind the perceived.  Consciousness is temporal and rational and ephemeral; existence is timeless, irrational, and foundational.  Consciousness is a means; experience is an end.

I don't wish to minimize the enormous importance of consciousness.  Our ability to consume our immediate environment, chew it up and regurgitate bite size pieces of meaning allows me to shit in a toilet instead of the dirt and to communicate with pixels instead of rocks.  What I am trying to say is that the packets of information, the ones and zeros, the rational articulations of otherwise meaningless atomic relationships that constitutes the intentionality of consciousness is not a state of being.  We are so wrapped up in the creative usefulness of the objects of our intentions, we lose sight of their purpose: that our forks and knives, our two-party systems, our dogmatic deities, our investment portfolios, and our misplaced and overanalyzed personal identities should enhance being.  They are means.  The goal of these and all conscious intentions is to eliminate conscious intention; to become pre-reflective.  The goal is to be.  

So don't think about it.

I'm back but nothing I say means a damn thing.

I'm back for what that's worth.  Back in the sense that I am writing today.  The experts are in deadlock whether I'll continue tomorrow.  There is speculation, odds, percentages, gut feelings, but in the end no one knows if I'll be back. 

But never fear.  What I don't say carries the same weight as what I do say: nothing.  My words are meaningless.  My blank space is meaningless.  What you get today is what you'll get tomorrow.  Meaninglessness is perennial, omnipresent, a trusted friend.  Meaninglessness is ironically something you can have faith in; a place to hang your hat when Jesus' or Buddha's coat rack isn't quite the right size.

Why am I meaningless?  A better questions is, what does meaning mean?  A hammer is a hammer in the context of nails and buildings and people who use nails to make buildings.  Otherwise it is wood and metal.  Of course, wood and metal carry their own meanings.  So it is atoms and electrons and neutrons and other microscopic round revolving shit that meet to form hard, heavy, and cool.  And, of course, hard, heavy, and cool require someone or something to perceive it. 

Meaning is relative.  It is shared patterns.  It is tones in conflict that, if left alone, would simply be a monotonous alarm but together mark Beethoven's Fifth.  For the little black pixels that make up letters and sentences and paragraphs and pages to become a thing, a hard, heavy, and cool ideological hammer, I need some kind of nail.  And I need something to build.  

The problem is I have nothing to build.  I have no nails and no direction.  I have fingers tapping out some unknown code whose origin is still not clear.  I am not building I'm exploring.  There is no relationship to my words.  They exist as they are because whatever I am exploring (me?) exists as it is.  My words are as meaningless as my silences and my silences are as meaningless as me.  They simply exist just as I simply exist.  

Or at least I wish I could simply exist.  I wish I wasn't a description to those who know me nor a calculation to those who don't.  I wish I ate spinach and believed "I am what I am."  In the end, I wish that my meaning was derived from my being and not the other way around.  I wish what I say really doesn't mean a damn thing.

Should I Jump?, or Rocks Sure Have It Good

Like I said the other day, I'm constantly hunting for methods to create purpose (i.e. meaning) in my life.  Methods to the madness.  Better yet, methods to the meaninglessness.    I firmly believe that I create the meaning in my life.  But creation is irrational and exploratory not logical and systematic.  In other words, I don't know what I'm thinking when I create meaning.  I kind of dick around until something fits (what a fantastically inappropriate way of saying that; so inappropriate, I can't bring myself to delete it).

So I get frustrated.  Nothing except my daughter adequately fits a satisfactory sense of purpose in my life.  Much comes close, but there is always some microscopic failure that I cannot articulate.  I try and fail.  I try.  And fail.  However, no matter how many times I fail, I can't stop.  I require meaning like I require air.

There is a sadistic piece of me, albeit barely perceptible, that unconsciously fantasizes about the demise of meaning in my life.  It's like the itch you get in your feet when standing on a ledge: what if I jumped?  What would really happen?  The irrational (stronger) part of my brain insists on the existence of meaning.  The logical (weaker) part of my brain knows meaning is just a conglomerate of distinct fragments of bullshit glued together on a background of nothingness in my brain. My life will eventually end in meaninglessness.  Any thoughts of immortality are a joke.  (What do you think about your great grandparents?  Probably don't make a meaningful impact on your daily life.)  So why struggle with it so much now?  Why cling to the impossible?

I do not want to lose that which is meaningful in my life (see Babies and Suicide).  I wonder if there is something in between?  An intensity of being.  An existence with an imperceptible self.  A purposeless now.  I wonder if there is a way to be a rock.

I've got a lot of shit

It's true.  I've got a lot of shit.  I've got a lot of shit because I have big plans.  Big plans I tell you!!  

I'm going to be a martial arts master.  I've got the belt, the gloves, the tape, the bag, the pads, and the timer.  I'm going to be a philosopher.  I've got Nietzsche, Sartre, Camus, Heidegger, Aristotle, and Plato.  I'm going to look like Hugh Jackman in Wolverine.  I've got random shit for pull-ups, push-ups, swimming, running, biking, kayaking, surfing, and SCUBA diving.  And I've got a full length mirror.  I'm going to be a writer.  I've got plays, screenplays, novels, short stories, children's  and how-to's stacked shoulder high.  I'm going to be a musician.  I've got a bass guitar.  (I know that is a little weak, but in my defense, it's an expensive bass guitar.)  I'm even going to be a better clinician.  I've got books on neuro, cardio, trauma, pharm, GI, babies, vaginas, exams, machines, and books on books I can't live without.

Alright!  So I'm ready to fulfill my big plans: the writing, philosophizing, rock-star anesthesiologist who can beat your ass if you weren't so paralyzed by the sight of his monster pecs.  

I'm ready....but I'm pretty sure there is a new book on the minute pharmacologic digitization of cerebral membrane proteins in the perioperative period.  Can't be an anesthesiologist without it.  Of course, there is also the handheld Swedish sure-grip ab builder and a 2-week camp on the Tao of fucking some fools up.  Can't forget the neon green dive computer for existential treasure hunters (the treasure, in the end, is meaningless) nor the guitar hero heavy bag that you pound to the beats of Jay-Z.

I'm piling shit upon shit in preparation for my future self.  I'm building an anti-existentialist bomb shelter: when meaningless overtakes us,  I've got enough crap to pretend I have purpose for years.

But what about right now?  What am I doing this second?  I'm writing.  I am a "writer" because I am writing, not because the Art of Dramatic Writing or the Marshal Plan are collecting dust on my shelf.

So as of yesterday, I don't have as much shit.  The local charity does.  And hopefully I'm not just making room for different shit.  Hopefully I'll start looking at who I am and what I'm doing instead who I could be and what I'll do.

Jesus saves snowboarding from cancer

If you've ever snowboarded, you've probably experienced the skill bolus you seem to get the second and third days.  I went from a red ass and frozen legs from falling on the bunny hill the first day to a red ass and frozen legs from taking jumps on the intermediate runs the third day. Granted my athletic abilities are near perfect (I like to put lies in my entries to throw your scent off and maintain my anonymity), but I suspect it is a similar occurrence for most everyone. I don't think my technical skills improved that much over a course of two days, however. What I think happened is I gained confidence. Instead of a tendency to lean back so I could force a fall if I started going too fast, I started leaning in and accepting the speed. I was less afraid because I was more familiar with what to expect. I was less self-conscious.  I wasn't thinking about what I needed to do to protect myself and was, therefore, not analyzing my every move.

I don't believe that a cross, a buddha, an ohm, or a naked lady tattoo confer actual physical protection.  I do, however, believe that they provide an alternative to self-consciousness provided that the user places significance on the object.  It will protect me so I don't need to protect myself.  I can concentrate on the task at hand and not on myself.  I would argue that, even though I am placing my security in the hands of something that truly only exists in my head, this puts me at less risk.  Often the true danger is in one's head.

Such a symbol can help the ill as well.  I've already hinted at this with my Surrender entry: the physician becomes the symbol.  Disease is a scientific description; illness is what the patient experiences.  Finding one's "new" identity lies in between.  (Imagine the identity crisis one undergoes when s/he feels fine but is diagnosed with a disease with a treatment that causes the patient to feel horrible.  To justify the acquisition of illness by the treatment, one has to redefine oneself, often as "sick".)  I can think of no other time in a person's life that they are more self-conscious than when one loses his/her identity.  As physicians, we need to consider this as part of our patient's illness: an acute sense of self-consciousness.  Symbols may be the treatment for this.  Of course, 9/10 symbols actually get in the way of what I feel is the proper course of treatment.  But a blog for another time...

Pattern recognition and an identity crisis

What the fuck am I? (Too many "fuck"s in this blog? It just works so well at getting readers...) You'll definitely notice an identity crisis weaving it's way through these entries. I guess it's not so much a crisis as I am content with not ever finding out who or what I am. I do believe, however, that the search is a necessary and vital process. In other words, my identity - my life for that matter - is boiled down to a fruitless search. In order to prevent utter personal chaos, the process then has to be the goal. And since meaning is a human construct (yes, I will be serving drinks and similar bits of bullshit wisdom in hell) and a rite of consciousness (more nails in the a-religious coffin), brain-chaos-containment is meaning.  So, Aristotelian logic leads us directly to the idea that I have discovered the meaning of life: process not achievement. The world is now saved. You're welcome America (standard hilarious Will Ferrell).

But back to question at hand: what the fuck am I?  Phenomenology has us bracket our perceptual habits and start fresh (more on phenomenology when I know what the hell I'm talking about).  So starting fresh: I am atoms.  I am carbon; I am oxygen; I am hydrogen; and I am sprinkles of other molecular crap.  The table my computer sits on (I won't discuss the computer itself because I don't pretend to understand whatever magic the Warlock Jobs used to create it) is also made of similar, if not identicle, molecular crap.  So what am I in relation to it?  I am exactly that: a relationship.  When I see myself in the mirror, I am looking at the same particles as I see in a cat, or a table, or tree.  I am different because of the relationship of those particles.  I am a pattern, not a substance.

What does this mean?  I am a construct of my mind.  My brain interprets the relationships and creates me or the table or the tree.  I don't exist as I think I exist outside of my head.  So what the fuck am I?  I am whatever my mind wants me to be.

Does anyone know how to fly this thing?

Flying freaks me out. Never used to but, since the advent of my daughter, the almost nonexistent risk is magnified. Am I really going to risk not being able to see my daughter grow up so I can rock out with Soungarden at Lollapalooza (top five shows of all time by the way)? The answer is of course yes because I know I am an irrational jackass. My friend is more of an irrational jackass than I am. She is remarkably courageous in my opinion because she flies despite her fear (courage is not a lack of fear but what you do with that fear).  We shared a flight from LA one time.  We started out in a torrential rain and she asked one of the stewardesses if it was safe to fly.  The stewardess said yes and that they too had an interest in living and would therefore not taking on any unnecessary risks.  

This is a very important concept.  The pilot and staff on the plane assume the same risk as the passengers: we all go down together.  It is not as obvious in medicine that we share the same risks as our patients.  I would argue, however, that this is absolutely the case.  There are questionable statistics on the limited life spans of physicians.  I can't honestly say what's right.  But it is clear we have stressful jobs and the burnout rate is astronomical (think about how this affects patients).  I can say from experience that if you do poorly under my care I am affected whether its my fault or not.  There are anesthetics that have changed my life, for both better and worse.  In addition to the baseline empathy we non-psychopaths share with other humans, we are tied to our jobs (and thus you as the patient) through the exceptional amount of time, effort, and sacrifice we put in.  My identity is inextricably linked to my profession (think about how you answer the question 'who are you'; I'm a father then a husband then an anesthesiologist then some other shit I can't remember, but I only mention the anesthesiologist part).  Consider also the patient who comes in who is nearly identicle to me except with a life threatening disease.  I am unconsciously tied to his outcome if only to protect my fragile concept of my own mortality (if it can happen to you, it can happen to me).

When you come under my care, we take the journey together.  We share risks. My say is equal to your say.  We forge a path together, neither of us directing the other.  I have the most knowledge of the controls so I'll be flying the plane.  I won't, however, drop you off in Minnesota when you're expecting Kansas City.  I'll do my best to avoid the uncomfortable bumps that are familiar to me but terrifying to you.  And I hope that you respect me and my stake in this journey enough not to force me to land in a pile of shit.

Identify with your disease

My guaranteed to read lead in is this: Fuck.

The origin of this lies in the fact that my "Patience" entry is the highest rated.  I am certain that it isn't the quality of the writing but the fact that the word "fuck" reveals itself in the first sentence and has two encores in the first paragraph.  Everybody loves the unnecessarily inappropriate.  I'd love to hear the top ten words that would get you reading (ear muffs everybody: fuck, shit, balls, cock; are you listening Google?).

Now that you've gotten this far, on to identity.  I don't know who the hell or what the hell I am so this will be an oft-treaded topic on this blog. I don't think I'll ever really know who this person who fakes my narrative truly is (there is so much redundancy and feedback in that sentence - I, I, my - I'm getting nauseous; I truly am a strange loop).  I refuse to read The Ugly Duckling to my daughter because I don't want to give her the false impression that we ever figure out who we are.    Maybe that's Buddha and Sartre's point anyway: defining yourself is succumbing to entropy (energy not available for useful work).  If I am what I am, the process is complete.  I am not available for useful work (i.e. the process of becoming).  I am a pinpoint.  I am stagnant.

But that is a topic for another day.  What concerns me here is identity and disease (there is a great book called Human Identity and Bioethics if you’re interested).  My god is the physical process.  I wouldn’t say physics per se because physics is a construct for understanding.  I simply mean that everything as we understand it is an infinitely dissectible set of processes: the unicellular organism driven by physical forces shares work with other organisms forming multicellular organisms that become increasingly more outwardly complex, but still driven by the same basic forces.  We are simple patterns of cause and effect (I don’t actually believe in cause and effect to be honest - blow your mind on this: Backward Causation).  Consciousness, free will, morality, spirituality are all versions of an uninterpretable chaos of physical processes.  I am that zygote in my mom’s uterus (just opened up a shit-can for the pro-lifers).

This means that we could not be anyone or anything other than our diseases.  Whatever the arbitrary classification of disease that my body will eventually degenerate into, that is me.  It is part of the process that is me.  If I were to define myself by the personality that emerges from the chemicals in my brain, I would have to define myself by the disease that shares the same chemicals, cells, and physical causation.  It is the ultimate Catch-22: you couldn’t live without the disease that’ll kill you.

The mini-van and the death of self

My wife won't let me buy a mini-van. I want one because it's spacious; it has little TVs that silence two-year olds; it can go the 80 miles an hour that I don't go beyond anyway; it allows for easy clean-up of the ill-defined baby particles that seem to make their way onto the floor and seats; and it has floor stow away things that serve no real purpose but are cool anyway.

But it's a no go. It's a no go because it marks the death of what we could be. Our future rock star selves. The one's that put the baby to bed at 7, arrive by plane to the Baja coast by 11, drink shots dripped through each other's ass cracks, and be home in time to film our American Idol audition songs before our baby wakes up. A mini-van marks the death of a dream. We are our parents. We are the middle class.

I am the worst perpetrator of this fallacy of identity. I am a writer even though my books and plays and whatevers haven't been written yet. I am a jujitsu master that can defend my family with Jason Bourne-like skill even though I haven't really committed to practicing the art. And I am a great husband and father because of these things I'm going to do, not the things that I am doing.

This is a big problem; a big, under-recognized problem. It is not the dreaming that's an issue. I believe possibility to be a great source of inspiration and productivity. It is the narrative we build - that thing we create to bridge the pinpoints of our lives into a false fluidity - that is the problem. Somehow with our perceived future weaves its way into our present and, in some ways, dominates it. We begin to think we are what we want to be.

Sartre stated that we are what we are not and not what we are. Utterly confusing but expected from a man who thought he was being chased by gigantic lobsters through his amphetamine haze. Confusing but insightful. We are what we are not: we are our projects, our expectations, our goals. We are not what we are: we are not our present selves but instead what we are working towards. To some extent this is healthy. If we cannot own our future selves in some way now, what would be the point of working towards anything? Sartre was a perfect example of how this can be healthy: he was striving towards something but actively doing something about it now. He was a philosopher and writer so he wrote everyday (enough for 20 pages a day for his entire lifetime). He was active. He lived his future in his present.

I don't think most of us are like him. We get lost in what we are not. I explain why I'm a writer instead of writing. I explain to my wife why I'm a good husband instead of doing what it takes to be one. I abstract myself from my present.

I'll be coming back to this idea of the present a lot. Although impossible to pinpoint, this now, this present, this whatever the fuck this is that we're truly living in is the only thing that's real. The past is misconceived, misconstrued, and misinterpreted. The future is undefined, unpredictable, and unsustainable. The present defines us. The rest is false narrative.

But fuck the mini-van. I'm getting a Porsche. It fits my Hunter S Thompson meets Bruce Lee persona better anyway.

Sartre: www.sartre.org/
Stow-Aways (love 'em): www.helium.com/items/785698-pros-and-cons-of-stow-n-go-seats-in-minivans