Monthly Archives: October 2018

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Life would not yield to Age

There are times I think I’ve missed out on a lot. It seems to me that in my day, if a man re-chose a woman, he would almost always go for someone younger than himself. The reasons were obvious even then: overweening hubris, and expectations beyond capability. Indeed, dating sites online still seem to confirm my impression, and often -if not usually- the man’s eyes prove bigger than his stomach and the meal seldom lasts.

But retrospection is a stew of disappointments often sprinkled with only the barest soupçon of hope. Age is, well, age after all, and things happen as we get older. So, especially if one partner is significantly younger when they meet, the inevitable will occur -and worsen- in the older, and so you can guess who will become the default caretaker. Despite the best and most honourable intentions, this strikes me as unfair, albeit easily predictable by anyone watching from the sidelines.

And yet, although I concede that I am a creature of my era, I am still willing to be a witness to the triumph of hope over experience, so I was drawn to an article written by Gary Karantzas, an associate professor in Social Psychology/Relationship Science, at Deakin University (Australia) in the Conversation online magazine: https://theconversation.com/mind-the-gap-does-age-difference-in-relationships-matter-94132?

‘Across Western countries, about 8% of all heterosexual married couples can be classified as having a large age gap (ten years or more). These generally involve older men partnered with younger women. About 1% of age-gap couples involve an older woman partnered with a younger man. About 25% of male-male unions and 15% of female-female unions demonstrate a large age gap.

‘But what these trends tell us is that the majority of the population is likely to partner with someone of similar age. This largely has to do with having social circles that generally include peers of similar ages and being attracted to others who are similar. Similarity entails many things, including personality, interests and values, life goals and stage of life, and physical traits (age being a marker of physical appearance).’

If the article had stopped there I imagine I would have learned nothing new, and I might have remained an insufferable avocat du diable at dinner parties. But, fortunately for both me and my friends, I read further. ‘Many people assume that age-gap couples fare poorly when it comes to relationship outcomes. But some studies find the relationship satisfaction reported by age-gap couples is higher. These couples also seem to report greater trust and commitment and lower jealousy than similar-age couples. Over three-quarters of couples where younger women are partnered with older men report satisfying romantic relationships.

‘A factor that does impact on the relationship outcomes of age-gap couples is their perceptions of social disapproval. That is, if people in age-gap couples believe their family, friends and wider community disapprove of their union, then relationship commitment decreases and the risk of break-up increases. These effects appear to apply to heterosexual and same-sex couples.’

‘Another factor at play may have to do with the stage of life each partner is experiencing. For instance, a ten-year gap between a 20-year-old and a 30-year-old may bring up different challenges and issues than for a ten-year gap where one partner is 53 and the other is 63. This is because our lives are made up of different stages, and each stage consists of particular life tasks we need to master. And we give priority to the mastery of different tasks during these distinct stages of our lives.’

And he concludes that ‘The success of a relationship depends on the extent to which partners share similar values, beliefs and goals about their relationship; support each other in achieving personal goals; foster relationship commitment, trust and intimacy; and resolve problems in constructive ways. These factors have little do with age.’

I think I witnessed something like that once. I don’t normally sit on benches, especially occupied ones, even though they’re usually long enough to support a small family. Of course, maybe that’s the idea, because they often have little plaques commemorating someone who has died but used to sit there. So I feel a little uncomfortable sitting beside people who might be related to the deceased. And anyway, the act of sitting on a bench at my age makes me think I should be finding an unplaqued one so my own family can have one printed up.

But, I was tired and the bench that overlooked Vancouver’s English Bay was seductive, even though two people had already discovered it for a rather snuggly chat. They were both gazing lovingly into each other’s eyes and speaking softly to each other. I sat at the far end of the seat so I wouldn’t disturb them. I don’t think it bothered either of them particularly, although one of them, an attractive woman, probably in her early sixties, leaned even closer to her friend to whisper something when I sat down. I have trouble judging ages, but I would think he was  ten or fifteen years her junior, and yet equally enthralled. Anyway, both of their eyes were so entangled I might as well have been a bird sitting on a branch nearby for all they seemed to care.

And then, perhaps thinking they were being rude, they both sat back and stared at the waves breaking on the nearby rocks for a moment. Finally, the woman turned to me and smiled. “Isn’t it a beautiful day?” she asked, as if she suddenly felt a need to welcome me to their bench.

I nodded pleasantly, and we all sat in silence for a while, listening to the cry of a group of seagulls that had landed on the rocks. “I hope I didn’t disturb you,” I suddenly blurted out, embarrassed at choosing an already occupied bench, I suppose, although perhaps more concerned about admitting to myself that I had needed to rest.

The man leaned forward and his eyes circled around my cheeks like butterflies about to settle. “Not at all. We were just reminiscing about how we met on this very bench fifteen years ago -fifteen years ago today, in fact.”

“I’d just finished running around the seawall, and I think it was a bit too far for me, so I needed to sit down… And I happened to see this bench,” the woman said, squeezing his hand as she spoke. She glanced at her friend. “Jeff was…”

“I was sitting at the far end of the bench reading a book when Alice arrived, and…”

“And that was the beginning of a wonderful life,” she finished for him.

It was sweet the way they both finished sentences for each other -like they were completely comfortable being inside the other’s head.

“It’s our fourteenth wedding anniversary today,” he added, and kissed her gently on the cheek.

“We come to this bench each year to remember,” she said snuggling closer to him and sighing contentedly.

“Welcome to our bench, eh?” he chuckled, and winked at her as they both stood up and stretched.

“I’m sorry, I hope I didn’t…” I started to say, but she reached out and clasped my hand, her eyes twinkling in the sunlight for a moment.

“It’s the meeting bench,” Jeff said, hugging her as he spoke, then grasping her free hand he stood quietly with her for a moment, the wind tussling their hair like another hand.

And as they started to walk away, Alice turned towards me and her eyes softened as they rested on my face. “I hope someone sits…”

But just then some friends further down the seawall waved and yelled at them, and her smile caressed me briefly before she shrugged and walked away with Jeff to grace some other lives.

 

 

 

 

 

 

 

 

 

 

 

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It’s About Time

‘What then is time? If no one asks me, I know what it is. If I wish to explain it to him who asks, I do not know.’ So wrote Saint Augustine, bishop of Hippo in North Africa, more than fifteen hundred years ago. And we’re still confused… Okay, I’m confused.

When considered philosophically, you’d think it would be a relatively simple concept: I exist right now: the Present; I remember what happened to me: the Past; I don’t know what will happen to me: the Future. That is Time. It is divided into separate Magisteria like scenes through the window of a moving train. And yet… and yet the divisions seem so arbitrary. So evanescent. It’s almost as if Time were merely an all-purpose synonym for Change. A generic label.

But things happen in time, our bodies being no exceptions, so it’s difficult to ignore. We have come to prioritize those happenings as constituting Time. The intervals between events have gradually become divested of significance, although whether it is the interval, or the event that is prime could be argued -much as whether the placement of a comma in a sentence contributes almost as much to the meaning to be conveyed as the words themselves. And yet, is it really all contingent…?

Are habits -those things we do almost without thought- or the endless train of happenings the commas? Is it actually in the intervals between things where we live? Do we inhabit the interstices, and merely mark their boundaries by events -rely on things that happen in order to count? Do we live between the nodes or does reality only exist for me when stuff happens, when I am aware of what I am doing? And if so, then what about when I’m not aware? What happens to Time then? Do you see why I am confused?

And, at the risk of sounding too Cartesian, is the reality my body inhabits different from the awareness my mind tells me about? Bodily existence seems to have been issued with different rules because it is far more contingent than my mind. Too needy. Too ad hoc, and less spontaneous. It seems overly pulled by evolution and ontogeny, unable to explore new things. It straddles the intervals like a bridge. It is a scaffolded entity, constantly in a state of repair.

No, Time, for a body at least, was always thought to be continuous. Contiguity of events allows restoration and medicine discovered this. It started on its quest to heal the body, even if the mind was not always in synchrony and did not understand. But it assumed that mind was only a by-product of body. It is… isn’t it…?

At any rate, something that has often puzzled me is the difference in prescription instructions for various medications. Of course some drugs are relatively short-acting, and need to be taken frequently, say, Q6H (every six hours), or perhaps they are more potent and require a smaller, but spaced out administration, say, Q8H. That seems fairly obvious, so instructions as to how much and how frequently to take them would therefore make sense.

But suppose the directions are to take them QID (four times per day) or even TID (three times per day)? By comparison, that seems almost sloppy, doesn’t it? I mean, what is the difference…? And how much variation is permissible between the timing of every eight hours, and three times per day? What impact would, for example, a two hour difference -or even more- have on the medication efficacy? This is not meant as a criticism, but merely an exploration of time in the administration of a treatment.

And yet, even a more precise prescription of the interval does not usually state a specific time for its consumption like, say, 8 PM. Given that our bodies (and hence probably our metabolism) are subject to a circadian rhythm, I’ve often wondered whether that might make a difference in a medication’s effectiveness. An article in Nature that I ran across addresses that very issue: https://www.nature.com/articles/d41586-018-04600-8?utm

‘The circadian clock is a remarkable system. A central timekeeper in the hypothalamus orchestrates a network of peripheral clocks in nearly every organ and tissue of the body, turning on and off a bevy of genes including some that encode the molecular targets for drugs and the enzymes that break drugs down. These clock genes are particularly important in cancer because they govern cell cycles, cell proliferation, cell death and DNA damage repair — all processes that can go haywire in cancer.’

Until recently, technology was unable to determine the genes involved, let alone the timing of their activation, and so chronotherapy remained on the fringe. But, ‘More than four decades of studies describe how accounting for the body’s cycle of daily rhythms — its circadian clock — can influence responses to medications and procedures for everything from asthma to epileptic seizures. Research suggests that the majority of today’s best-selling drugs, including heartburn medications and treatments for erectile dysfunction, work better when taken at specific times of day.’

Steroid levels, for example, ‘naturally cycle with the circadian clock. In the late 1960s, scientists found that the synthetic corticosteroid methylprednisolone is safer for treating arthritis and asthma if taken in the morning rather than at other times of the day. This is because the feedback loop in the hypothalamus, which controls the release of cortisol, is least vulnerable to inhibition in the morning.’ Other factors such as age and gender also seem to be important in circadicity. So is the inconvenience of the times when the appropriate genes might best be manipulated. Not only that, but ‘practical biomarkers are needed to help clinicians identify optimal times for treatment.’

There are many variables to account for, but clearly there is a growing appreciation of Time in understanding the body’s underlying physiology. There is a need to adjust not only the treatment, but also its provision in harmony with individually derived schedules that are often by no means intuitive or convenient. As if, by finding each body’s unique variations on the theme of circadian rhythm, we discover the hidden melody playing deep within.

Maybe Rabindranath Tagore, the Bengali polymath who won the Nobel prize in Literature in 1913, was not so far afield after all: Let your life lightly dance on the edges of Time like dew on the tip of a leaf.

I’d like to think we all dance in Time…

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Such Sweet Sorrow

I kind of figured sugar would sneak back. It always does! Just when you think it should be terminally ashamed of the stuff it’s done, it shows up as somebody else and fools everybody. I mean, forget trying to pretend that you don’t recognize it in a crowd, that you can’t see under its mask. Sugar is, well, sugar, eh? No matter how it tries to sweet-talk its way around you, it is what it does. Period.

But what is that? Apart from fuelling our atavistic requirements for easily assimilable energy, and therefore surviving early Darwinian whittling, I’ve often wondered if there’s more to sugar than meets the tongue. It has too large a presence in our world to be confined to pleasure alone. Almost every organism seems drawn to it. Should this be telling us something?

Every once in a while my overweening, but naïve hunches are rewarded with information that addresses much the same issues but in ways I hadn’t considered: http://www.bbc.com/future/story/20180328-how-sugar-could-help-heal-wounds?

Moses Murandu is a man who grew up in the rural Easter Highlands of Zimbabwe, and later moved to England to work in its National Health System. ‘A senior lecturer in adult nursing at the University of Wolverhampton, Murandu completed an initial pilot study focussed on sugar’s applications in wound healing and won an award from the Journal of Wound Care in March 2018 for his work. […] To treat a wound with sugar, all you do, Murandu says, is pour the sugar on the wound and apply a bandage on top. The granules soak up any moisture that allows bacteria to thrive. Without the bacteria, the wound heals more quickly.

‘In some parts of the world, this procedure could be key because people cannot afford antibiotics. But there is interest in the UK, too, since once a wound is infected, it sometimes won’t respond to antibiotics. […] And a growing collection of case studies from around the world has supported Murandu’s findings, including examples of successful sugar treatments on wounds containing bacteria resistant to antibiotics.’

Well, it’s safe to say that I don’t know how much sugars will contribute to our health and well-being, but they do serve as a reminder that western science is not the sole guardian of knowledge. Or wisdom. Answers are not rare -they are lying around everywhere just waiting for the right questions to discover them. The right curiosity. And we run a risk dismissing traditional enlightenment -folk wisdom- out of hand.

The problem, as I see it, is one of attribution. The credibility we assign each source should be determined by the results of testing its hypothesis, finding the appropriate question to interrogate whatever is proposed as an answer. Finding the key that fits the lock… And the thesis investigated does not have to be of mind-bending importance; science is not the exclusive purview of people in white coats. Nor those of a certain age…

I recently happened upon a Tim Horton’s café in close approximation to a message from my stomach that it needed both a coffee and a bagel. Not being in the mood to argue, I decided to accede, although my loyalties normally lie with Starbucks. I had been wrestling with the question of habit on my walk –my strange unwillingness to explore new ground, consider new sources. Tim’s could be the answer waiting for the question.

Science, if it be considered from the inductive perspective, I reasoned, required the inference of laws from particular instances -answers from the right questions. In other words, Propose, Test, and then validate or refute. It isn’t enough to simply assume…

I had chosen a busy time unfortunately, and I was lucky to find a single table in a corner by the window. It was squeezed between a group of elderly women crowded around a larger table busy consuming their donuts and politely slurping their coffees, and a small table like mine occupied by a harried looking mother trying to bottle-feed a squirming, unhappy baby in her arms and a young boy busily kicking the legs of his chair.

The elders were surprisingly quiet, but not the little boy, so my ears naturally focussed on him.

“Why can’t we go, Mommy?” he kept asking.

I could tell his mother had almost reached the end of her tether, and she stared at him crossly, determined not to interrupt the feeding. “Because I’m still feeding Janny, Tim,” she replied, tensely. “She’s really hungry.”

The boy tilted his head curiously. “She’s squiggling around; she’s not even sucking…”

At that point the baby began to cry even louder-scream, actually- so the mother put the bottle on the table and positioned the baby on her shoulder to burp it.

But Tim still looked puzzled. “But she doesn’t like the bottle, Mommy,” he said, as if his mother should have noticed by now.

His mother shrugged, almost in tears. “I know, Timmy, but you were hungry too, remember? That’s why we came in here instead of going back to the car.”

Tim sat back in his chair for a moment to process the problem. “Well, why don’t you let Janny suck your breasts?” he said, in the rather loud voice of a four year old.

I could see his mother blush as soon as he said it, but Timmy had merely proposed a tentative hypothesis that could easily by tested to see if he had asked the right question, and his face was as innocent as a new nappy.

His mother leaned over the table with Janny so she could show Tim that they could talk quietly about it. “I would if we were sitting in the car…” she said, but he continued to stare at her, still puzzled. “And the car is still a long way away, Timmy.”

Tim leaned over the table like his mother. “Why can’t you breast her here?” he asked innocently.

She smiled and glanced around the room, embarrassed. “Some people don’t like to see mothers breast feed their babies in public.” She tried to whisper but Janny was really screaming now. She glanced at the washroom, no doubt wondering if she could feed her baby in there, but it must have been a small room, because there was already a line of needy hopefuls that had formed at the door

Tim smiled as if he knew how to solve the problem with his initial hypothesis, and he leaned towards me on his chair. “Hey mister,” he said in his best, grown-up voice, “Do you mind if Mommy breasts Janny in here?”

His mother was now beet red, and she glared at her little son and then attempted to smile at me. “I… I’m sorry…I…” But she was too embarrassed to continue.

“I don’t mind at all,” I said, trying to reassure her with a reciprocal smile. “You can use my jacket to cover yourself, if that would help…” I said, beginning to take off my jacket.

One of the elderly women at the next table leaned over and gave a thumbs-up to the frazzled mother. “We’ve all been there, dear,” she said and winked before she turned back to inspect her plate for donut remnants.

I handed the mother my jacket and the baby settled into the welcoming breast somewhere underneath. Propose, test, validate…

I added some extra sugar to my coffee, and settled back in my chair to celebrate the triumph of citizen science that even a child could perform. It’s just a matter of finding the right question, after all…

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The Grey Dog

I was once a moody child; I’m still a moody child… sorry, adult. Anyway, I’m also a bit sensitive about the topic. It’s as if being moody means being naughty, or maybe contrary. Not quite right in the head, or something -not well adjusted, at any rate. I take exception to that. I mean, just because I often have trouble mixing with people at parties who only want to make small talk -usually about other people- and then walk away shouldn’t disqualify me from church or anything… Okay, I don’t go to church, but you see what I’m driving at, I hope. Moods are kind of baroque frames around my happiness. They make even run-of-the-mill joy look like ecstasy.

I’m not advocating ignoring the more severe and persistent forms of mood -they may in fact herald something very important. I am saying that not all of us who are occasionally disgruntled, frustrated, or unhappy have some underlying pathology. And to label those occasions as bouts of depression is to dilute the word, mistake the condition, assume everything is the black dog.

I was therefore relieved to find someone who relates to that view:  https://theconversation.com/is-my-child-depressed-being-moody-isnt-a-mental-illness-92789

The author, Dr. Stanley Kutcher, Sun Life Financial Chair in Adolescent Mental Health, at Dalhousie University, Begins by noting that, ‘[…] if the media coverage is to be believed, we are drowning in a sea of mental illness that threatens to overwhelm post-secondary Institutions. […] The prevalence of mental illnesses (defined using clear diagnostic criteria) is not rising in this cohort.

‘Youth self-reports of negative emotions are increasing. But the self-report scales used in studies documenting this have not been calibrated for generational changes in language use. Nor have the results been validated using clear, clinically valid, diagnostic criteria applied by expert clinicians.

‘[…] The above noted self-reports do identify the ups and downs of everyday emotions, but these are not criteria for diagnosis of mental illness. So we can say that youth on campus may report feeling more negative emotions than previously, but this is not the same thing as saying that young people have more mental disorders than previously.’

He cites an interesting example of the lack of application of basic critical thinking and analysis: ‘In late 2017, the study “Mental ill-health among children of the new century: Trends across childhood with the focus on age 14” was published by the National Children’s Bureau in the United Kingdom.

‘This showed that self-reported negative emotions were present in about one quarter of this surveyed group, but this was interpreted as 25 percent of 14-year-old girls in the UK suffer from depression! The fact that parental reports identified about five per cent of this cohort as having significant mood problems was ignored by almost all commentators. This latter number is much more in keeping with known rates of depression in the population.’

I wonder if our expectations of normalcy are to blame. As Dr. Kutcher explains, ‘These concerns are not the result of substantial epidemic increases in the rates of mental illness. They arise, in some part, from poor mental health literacy and unrealistic expectations of the normal emotional states that life challenges elicit.’

He makes some interesting and important points, I think. ‘[…] First, the increased public perception that being well means only having positive feelings is taking over the social discourse on mental health. When the measure of health is simply feeling good, negative emotions become a marker of being unwell. […] Without addressing the life challenges and opportunities that negative emotions signal to us, we can’t develop resilience. Mental health is not a static concept wearing a big smile. There are good days and bad days, good weeks and bad weeks. We still have mental health even if we are having negative emotions.’

‘Second, the use of words originally developed to identify mental illnesses to describe normal negative emotional states has burgeoned. […] Further, the use of terms denoting illness, such as depression, to mean all negative emotions is even more confusing. Now, words like sadness, disappointment, disgruntlement, demoralization and unhappiness are all lumped together as depression.’

He feels that the continued and almost obsessive use of technologies like smart phones for communication-especially by the young- may limit their ability to express complex messages and ideas and hence increase the sense of isolation, of being misunderstood -or perhaps, of even being mislabelled. And since it is adults, by and large, in charge of the classifications, it’s almost a case of two solitudes, two Magisteria, staring at each other -neither the wiser. Neither the winner…

Interestingly, I think I caught a whiff of this while waiting for a bus the other day. Two quite young teenage girls were sitting on the only bench in the little shelter, both clutching their mobile phones like purses. Because the rest of the bench was filled with their back-packs and some school binders, I merely stood outside and leaned against the wooden frame.

“But what did he say, Kitty? Is he, like, mad at you or something?” This from a petite little girl with long, straight dark hair and a big red coat with only a pair of blue boots sticking out from the bottom.

Kitty shook her head and leaned back on the wall of advertising behind her. She also had dark hair, but short and messy. It fit rather well with a large, thick and ragged blue sweater, torn on at least one sleeve to show a thin arm underneath. Her jeans were also fashionably torn, but looking as new as her pink running shoes. “No… Not mad… Just, like, upset. He says I’m moody -and all because I don’t want to, like, talk with him and Mom at the dinner table. I mean, nobody, talks anyway.” She shrugged theatrically and leaned forward on the bench again.

Her friend sighed sympathetically. “Yeah, my mom keeps wanting me to… you know, like communicate with her, too. But I mean, ever since dad left, she’s always either on her phone, or has the TV on.”

Kitty, nodded. “Yeah well, like, my parents think I should see a counsellor at school… They think I’m depressed, eh?” Her friend’s expression tightened, but she stayed silent. “But my dad always has his phone on the table and, like, keeps glancing at the news on his apps or, like, he’s waiting for an important Email, or whatever. And my mom’s a realtor, remember, so she does the same.” Kitty glanced around the wall and saw a bus was coming. “That’s all they talk about, anyway, Jen.”

Jen was staring intently at the ground in front of her. “Well, I think my mom’s depressed, you know, but she won’t go see anybody about it.” She took a little stertorous breath. “She thinks she’s coping… But I think, like, she’s just escaping online and stuff…”

The bus pulled up, and Jen seemed on the verge of tears, so Kitty reached over and hugged her. “We have to be strong for them, you know, Jen…”

That’s all I heard before they quickly gathered their things and walked over to the bus, arm in arm. Kitty must have whispered something else to her, because they both started to giggle before they got on.

I don’t know if it’s the technology, but it did make me wonder whether we really have a handle on mental health yet.

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Time

Days, half awake, immobile as old men leaning,

Hours stacked in untidy piles around the room,

Minutes stretched along the walls like arms, unlinked-

All immune to the pale blue infection on the window’s breath-

Lounge, cow-eyed

In the tedious drag of shadows across the floor.

And me?

Forced to spend what seem like years

Making patterns in ceiling tiles,

Watching the leisurely dance of dust settle on the slowly tasting tongue of sun drying on the carpet,

With each blink a novelty -an unexpected marker-

I feel time physically now.

It is an object,

Not as the soundless tick of something on my wrist,

Or the arbitrary sweep of points around a circle.

It is real-

As real as the skin that stretches with each breath

Or the weight I carry with me in the chair;

It pushes at my thoughts,

Separates and softens them.

It sits like an anchor inside my chest

Defying me to move,

Settling all the while, like gravity, further in.

At times it burns, swallowed half-chewed,

Force-fed in each breath:

A worm eating patiently deeper.

And yet it is a soft-grey porridge boiling over,

Coating word-bright seeds,

Planted in a darker bowl behind.

It is a body-bag, this Time-

Not at all the process I had thought.

Not a measure, not another way of pointing north,

It is the monkey on my back,

The sentence never finished