Wednesday, January 23, 2019

A Dislocated Shoulder

I would maintain that the worst part of dislocating your shoulder is wearing a sling for 6 weeks. But that's probably I misuse of 'worst', I for the record, don't wear a sling for 6 weeks or at least don't anymore.

Yes it is painful to have a dislocated shoulder, and while the shoulder is out, you are persistently conscious of the fact that it should be in, but in terms of debilitation, it's actually the rehabilitation of which advice is very inconsistent.

I've had doctors tell me I should be sleeping in a sling with the joint completely immobilized, and other doctors advising me not to play tennis or hockey while the joint heals up. I tend to follow the advice of the latter.

Why have I had so much differing advice? Because it's a recurring injury, that tends to recur in novel situations as I learn the limitations of my now stretched ligaments.

Now if I were to find a magic talking sandwich that granted me a modest wish in return for saving it from being swept in the trash, would I wish my experiences of being out of joint away?

Probably not, and not because it has given me legitimate circumstances under which to alter my state of consciousness through pharmacology. I've been injected with morphine and huffed it, inhaled NOx and on one occassion, been dosed with ketamine and sent into the k-hole while my arm was reduced. 

But I actually prefer the two occassions where my shoulder was put in drug free. Once in Kyoto where the doctor asked me if my shoulder usually goes back in easy, and I said no they always have to use drugs, and he said 'we'll let's give it a go' and I said 'okay' and then a nurse pinned me down, and I yelled out 'itai itai itai itai' and he completely ignored these and just pushed through my pain.

A few days ago here in Guadalajara the second doctor on the third attempt got my shoulder back in drug free while the other doctors refused to pin me down (a request I made based on my positive Japanese experience) and the only aneasthetic I was administered was the doctor who could speak the second most English repeatedly assuring me to 'relax bro.'

I have picked up enough Spanish to relay between attempts to the doctor 'Lo siento, mi mente es el enimigo' (I'm sorry my mind is the enemy). 

Which it is, as has been explained to me on other occasions, the shoulder wants to go home it wants to go back in, it's just that the muscles tense up and won't let it. This is why the day after your shoulder is put back in place it often feels worse for the good night's sleep. It feels like you've pulled every muscle in your shoulder because you have.

The experience is valuable though, because it's a very visceral way to experience many important aspects of healing - healing can be painful and frightening, your own mind can work against you, you might have to trust people your ever fiber of body is fighting against.

Excruciating pain, is it's own consciousness altering state, but unlike say a pleasant escapist trip, my motivation is to return to sobriety.

And this is what I had to do. I had to force my breathing, force my posture, force myself to lay down and just let the doctors hurt me, I had to tell myself that my arm wasn't being ripped off, but being put back. I had to relax "bro".

Our medical systems for the most part separate body and mind. And treat them differently. I'm sure I've probably thrown together a sentence before to the effect that, if I was to collapse and convulse at home or on the streets, I would probably be bundled into some vehicle and treated by professionals. Same if I broke my arm or leg, or in this case dislocated my shoulder, except that I walk to the hospital when my shoulder is out.

The fact is, with maladies of the body, we are much pushier against what people may believe, albeit there are phenomena of recent times like the anti-vaxers and homeopaths and all that junk. 

But I personally am alarmed at the number of young people I interact with, that suddenly resemble a cranky old man saying 'I don't need no doctor!' when it comes to maladies of the mind. 

To me, there's a ridiculous, but instructive analogy to be drawn betwixt my fellows who 'tried seeing a psychologist but it wasn't for me.' and instead have figured out a way to cope with pain through some form of self-medication, and if someone were to be like 'I tried having a doctor reduce my shoulder, but it was painful and didn't go as easy as I expected, so I just leave it out and take heroin.'

Ridiculous I know, but I've never been able to understand why people debilitated by the more common, less dramatic but quite treatable mental maladies, would rather a daily debilitation than taking one of the many practical steps of treating it.

I suspect it's because often those steps are quite painful, quantifiably painful compared to the familiar dull ache, the death by a thousand cuts of staying as is. Drinking at the end of a working day, or staying in a disappointing relationship or what not, might in the immediate term be preferable to having to have a conversation with a kindly stranger in a comfortable office where one confronts the painful fact that their parents don't love eachother, or perhaps in practice... them, or that they love them but don't particularly like them...

And perhaps most painfully of all, there's a sunk cost type scenario going on where people are afraid to have their own bad faith disavowed and discover that through some talking therapy, through some CBT and changes to their physical and social environment, much of their suffering proves meaningless and unnecessary?

There's no equivalents to being dosed with Morphine, some kind of amnesiac drug, or sedative, where one regains consciousness to find their shoulder back in place for the mind. I mean you can take ketamine and maybe have a great time, but you'll come back down to reality and discover that shoulder socket in your mind is still empty. Perhaps the closest is Ayahuaska it's the only one I've heard credible testimony as to it's ability to induce a trip that actually potentially solves a real world problem.

I mean, recent resumptions in the clinical applications of psychadelics sound promising, but there's plenty of promising treatments out there already - CBT, talk therapy, Family Systems Therapy. Even garden variety situations that can go terribly wrong, like break-ups oftentimes involve a grieving process, but for some unlucky few can be a catalyst for unhealthy thought habits getting out of hand and into the drivers seat. I would guesstimate the incidence of people who get stuck in a relationship grieving process to be common enough that everybody knows someone like this, if they haven't experienced it themselves.

And perhaps there too is the best analogy of the situation - when a person keeps someone who passively makes them miserable - just by innocently existing - in their lives, rather than go through the pain of maybe missing some social functions, sheepishly telling people the relationship didn't work out or worse. 

To me joining a new social sporting club or other group seems far less painful than the visceral experience of having a dislocated shoulder reduced. Therein lies the reason I would say 'no magic talking sandwich, I don't wish for tighter shoulder ligaments, I wish to eat you, for I am hungry.' Once every couple of years or so, having to go through the process of trusting strangers, telling my shoulder to relax while it believes said strangers are going to rip it out, is just too instructive a metaphor for the daily suffering that is being a human in this chaotic world. 

Gotta do stuff that sucks today, so tomorrow will be better. Speaking of which, I should do some of that tedium that makes my tomorrows better...

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