The IWALLK Essays - 5. Why the Ghost Returned to the Machine

I've been studying up on the psychological shit that happens after open heart surgery. What I'm going through is subtle, in a way, but bizarre in many more ways. Latest stats indicate that 20-40% of people recovering during this kind of post surgical experience face anxiety, and/or depression, and/or fragile emotional states and/or dementia. I apparently am one of them. But I hope this essay causes folks to think before cutting a pigeon hole for me to stick my head into. 

There are a MILLION different post surgical experiences out there, recorded in great detail. Some match mine. Some have only certain aspects that match mine, and others just don't, and I wonder about the fitness of the minds of those folks before they even got heart disease. Anyhow...

So far, in the statistical medical research of post surgery like mine, it appears that changes in so-called "personality" seem to be either temporary or non-existent. But there are other explanations for behavior and “feelings” that skip over personality and go straight to emotional and chemical changes that have largely left the personality in tact, while also leaving the FEELINGS in tatters. (Please recall that "personality" is probably the most vague concept in all of psychology, besides the presence - or not - of a non-material mind {consciousness/soul}, separate from the brain.)

The first factor that seems to determine whether someone faces psychological difficulties is the pre-surgery state of mind. In this regard, I am an outlier. As is written in great detail here at my Facebook profile page (scroll down and see for yourself), I was feeling quite good about everything right before the surgery. Never had I felt such love and support from both my family AND friends, but also I felt as though I had wrapped up my life and tied it with a little golden bow—thence, ready to literally die and move on into the Golden Light. It would only take one cut in the wrong direction. No surgeon is perfect! I was NOT depressed, probably for the first significant amount of time since my childhood! Up to that point, I had never been a happy person. I'm a damn good faker though. As a child I had a smile that could melt the Washington off a quarter. But I have flirted with suicide and enjoyed suicidal ideation for all of my adult life. I've pretty much hated myself and felt that the Universe would be far better without me in it, every single day, since about my 8th birthday. This should not shock anyone who really knows me or has read my "stuff." And if it does I can't blame you. Wishful thinking is not a crime on your part.

But before the surgery, I was so sure that I was going to die (and would probably be in the process of dying on this very day, without surgery), that I was almost giddy about it! 

I was primed and ready to go. I know what's on the other side. I was more than happy to die now. My whole life seemed designed to make sense because of it. And, I've been waiting for my life to add up to something...well, something more than nothing. This was my opportunity to make the story into...a legend. People didn't respect all that I had done. But you can be goddamn fucking sure that people DO respect a martyr. It's the oldest game for being part of history since there have been games, or history. Just ask Jesus, Gandhi, or John Lennon. 

This seemed like my big chance to be free. And, as you will someday learn, I WAS freed from a terrible choice I made over 30 years ago, but even that profound spiritual liberation just pales compared to the general feeling of disappointment for not either reaching the Mansion Worlds of Light, or fading into the blackness of nothingness; both of which I was well-prepared for by the time tunnel vision was pulling me out of myself in the operating room.

I am pretty sure that waking up with a breathing tube in my deflated lungs, a catheter up my dick and a balloon in my sore bladder, an IV in my neck, my arm AND my wrist (just in case), a wired up breast bone that had been sawed in half (can you smell the spattering heated blood from the saw?), and a pacemaker sewed onto the skin of my belly, delivering painful electrical pulses into my poor, worn-out heart (none of this - by the way - was explained to me before surgery) was a pretty sharp reminder that I was back in the shitty human world of whales choking on plastic and reality TV presidents! There's no hell greater in its brutality and excruciation than this world. I know that for an absolute certainty now. 

The fading vestiges of my experiences in the place where my soul went during surgery were so poisoned and debauched by the extreme discomfort of the breathing tube once consciousness was returning that it ruined a once in a life/death-time experience. The medical staff refused to remove the tube as I begged and gestured to do so. I could have told my sister who watched all of this, about the vision of that Place that faded away as I was forced to pull myself back into the “machine” of my animal body. 

My life as a “whatever I am,” was coming back like a rerun of the worst Friends episode you've seen a hundred times and hate the station for replaying. And, there was a stupefying, yet sickening, satisfaction to the “been there and done that already” reality that was bringing me back here to do that shit all over again, in front of a bunch of people who are barely half awake and don't give two fucks about my existential crises, here, now that I'm back back in hell. So I thought.

Through the false lens of Hydromorphone, Oxycodone, and Lorazepam, I had a brief couple days of optimism. But the tired out blabbing of people who have never experienced what I was going through, telling me to “breath in through the nose and out through the mouth” whenever I literally screamed because couldn't lie in a bed to sleep, nor wipe my ass without feeling like my ribcage was being slowly ripped apart and wired back together over and over again, was supposed to comfort and calm me? All it did was remind me that I am ultimately just a heart-broken, tear-stained, worn out, piece of Universal detritus who couldn't even die successfully! Fuck, can't I do anything right?

Okay, that was perhaps unnecessarily intense. But that is the point I'm trying to make. The intensity of all regret, pain and suffering, is couched next to a man who has been given the miracle of a “second chance” (honestly, it was my forth chance) to fulfill a life self-designed before I was ever even a twinkle in either of my parents' eyes.

I know now (basically) what happened while I was away from my body. Besides being liberated from a deal with the devil, I knew that I was lying to myself before surgery. I knew somehow that I would survive, but was hoping not to. And, before any of you think I was just trying to “escape the realities of the human condition,” let me point out, that I deserved it. I've paid my fucking dues and a little bit extra for a bunch of other people too. 

I AGREED to come back. It is my fault that I am alive. It is the reciprocal event to the fact that it is/was my fault that I almost died! Do you see? It changes one of the stupidest and redundant sayings of my father into something amazingly profound: “The job isn't done until it's done.” I am the living metaphor for that statement.

And, as I heal my body for the next ten years or less (that's the statistical period before I begin to have problems again), I'll tell it far and wide... I was alive as a child, wanted to die as an adult, almost made it there, but was talked into being spiritually responsible for myself, and now I'm back. In the process my soul migrated a little more toward the outside. While, the Spark is much deeper within me, much more fundamentally controlling my thoughts than ever before.

Yet, with all of this complaining, I still can't escape the Truth: It was me all along! I planned it all out before the earth was even formed--as we have all done with our lives. Should I be so surprised that the day has finally come to publicly reflect on that—to finally grow up? I am back in order to finish my self-assignment. Pretty simple concept! I couldn't kill myself, since my Universe IS myself.

There is nothing else more important for ME to do. I want to spend the rest of my days here talking to you about why we are ALL here. 

But I will tell you, to each of your individual souls... WE are ONE thing. You are not separate from my story. The wet eyes that gaze upon this very sentence – YOUR eyes – are meant to see through mine and you are meant to express yourself through the typing of my fingertips. It is the end of history. And you can judge me by my experience all you want. But afterward all that, I am not here for you and never have been. Don't you see how you have been me? I am your mirror. And no intelligent person walks FORWARD using only a mirror. 

It is OUR story now. When I finally allow myself to find Paradise—the Center of Infinity, it will be with your hand in mine.

The IWALLK Essays - 4. The Pain Buffet

When you walk through the door you may be impressed and depressed by its high costs. The variety of excruciation offered can be staggering, and the chef never ceases to serve up surprises for you by adding new and creative recipes; some, you may need to Google in order to truly appreciate. But it's all there for you! It's “all you can take” at the Pain Buffet!

And, if you're me (or a million other people) and you need adequate pain relief for a temporary amount of time, you may find yourself spending most of that time seated there. Even if, on the other hand, your pain is chronic and not temporary, you will probably similarly be forced to endure spending much of your life there going up for seconds, thirds, fourths...

Metaphors aside, pain is a natural part of life. Here in the material world accidents happen--imperfection rules. Human animals have adapted naturally to a world where broken bones and bloody wounds catch us when we least expect them. But we usually heal. We don't always stay pretty as we accumulate the scars of space and time, but we do nearly always keep soldiering on, wiser than before. 

Pain is the hardest aspect to come to terms with though, because it always sucks. And the sucking is not just electro chemical signals registering physical discomfort in the brain. The much more painful aspect of pain is not what happens in the brain, it is what happens in the mind, not helped by the policies of a primitive society. 

For me, this is why not having adequate amounts of serious pain medication – specifically opioids – can be so unhealthy. Without enough of this kind of medication, stress increases, clenching unnecessarily tightens vulnerable muscles and tendons, and the normal resumption of daily activities can be unreasonably delayed. While waiting for my new Primary Physician some weeks ago I caught sight of a brochure that I didn't want to see. The gist of its message was that just about anything (acupressure and music therapy have been suggested) would be used now at the Internal Medicine section of Franklin Memorial Hospital in Farmington, in lieu of opioids for moderate to sever pain management. This isn't based on logic or historical wisdom, but rather on the recent media-enhanced, trendiness of the anti-opioid hysteria that is sweeping the nation. 

Big Pharma companies like Johnson and Johnson pushed doctors to over prescribe these medications. Then there was an inevitable reversion to the street use of dangerous and unregulated black market narcotics after these prescriptions ran out. The recent introduction of extremely powerful analogues, turning common heroin into unstable admixtures which include fentanyl and its sister analgesics, like carfentanil, have turned the needle into a loaded gun ready for Russian roulette. But, we must bear in mind that it is not the drugs, but rather the socially retarded policies around them, that are causing overdose deaths to rise dramatically. In 2017, 47,000 Americans died as a result of opioid overdoses—an incredible 9.6% increase from the year before. 

Yet, cooler minds are examining the situation and coming up with a more truthful assessment. According to a recent Peter Wall (no relation) Institute of Advanced Studies (University of British Columbia) lecture called, “Drug Use for Grown Ups,” given by Carl Hart – a neuropsychopharmacologist and distinguished Columbia University (New York City, NY) professor – over 90% of people who use drugs classically thought of as “addictive” or “hard drugs” never experience uncontrollable dependence upon these substances. The hype about the danger posed by “drugs” (the inaccurate catchall phrase) to the general population is entirely based upon propaganda. Many other thinking people are beginning to realize how unreasonable drug policy has been, especially since the advent of cannabis law reform and the coming days of probable federal legalization. Fear based prohibition has of course also been reinforced by the ignorant hyper-moralization of religious groups, racist politics of elected leaders and the erroneous emphasis on law enforcement over medical treatment.

It is this last category – emphasis on law enforcement over medical treatment – that limited the amount of necessary pain medication I myself received after my quadruple bypass surgery. In that kind of surgical procedure the sternum is sawed in half and cracked apart to access the heart. 

The post surgical pain of the healing process after the rib cage is wired back together is (as you might imagine) nearly intolerable at first, slowly diminishing over about a six week period. In the hospital I asked for something stronger than oxycodone (one or two 5 mg tabs, every four to six hours), because it just didn't touch the pain. They were required by law to do a Drug Enforcement Agency (DEA) background and criminal search on me before bumping the class of meds up to hydromorphone (aka Dilaudid, one to two 2 mg tabs, every four hours). This helped tremendously. Although I had to deal with a slightly more fuzzy head, I was able to get my mind off the pain enough to think about other things.

I was only in the hospital for four days including the day of surgery. They try to get patients out into the big ole world again as soon as possible—which is very reasonable and a good policy. Unfortunately not much thought was given to tapering the pain medication. So I went from 6 to 10 hydromorphone a day in the hospital, back to a prescription for 24 oxycodone tabs to take home, meaning I was rescheduled to take only 1 to 2 tabs every six hours—a significant reduction in efficacy by lessening the type of medication, and increasing the hours in between taking it. 

This was a huge jump and fired back up the amount of daily pain again to the point where I was not able to sleep well or think about anything else. I felt I had to skip doses at certain times of the day in order to hoard enough for night use. This was a ridiculously unnecessary subjugation, and limited the use of the oxycodone to a maximum of six days (out of a six WEEK recovery). 

When I was running low and still experiencing the same amount of pain, I called my surgeon's nurse and basically begged for a refill. After 10 minutes of groveling, she relented and approved a second refill. Of course, that was to last only another 6 days—maximum. During that time I was practically overdosing on acetaminophen (aka Tylenol), using 1000 milligrams every 4 to 6 hours, trying in vain to replace some of my doses of oxycodone, so that I could reserve them for extra painful episodes. When I got close to the end of my refill, I was suffering tremendously still, mostly at night (lying on my side in bed was an exercise in teeth clenching torment). Mercifully, I was also prescribed Lorazepam (a benzodiazapine 0.5 mg, for anxiety and to help with sleep). This made things a little bit easier to handle, in that I would be able to eventually fall asleep, but in the morning would be suffering intensely from lying in one position all night.

Although tolerance is a problem when someone is trying to get extra relief over the prescribed amount, ironically, NOT using enough medication can weaken even the normal dose. Opioids must also be “stacked.” In other words, it takes a pill or two for the body to recognize the efficacy of normal use when doses are skipped. If you cut it down to nothing, where you had formerly taken a dose, then take only one pill, it does not have the same power as the continued use on a regular schedule. This can be a maddening cycle of inadequacy.

When I had tapered down to taking one oxcodone a day, trying to deal with almost the same amount of pain as I had after surgery (made worse by a cough), I decided to try getting something else from the surgeon's nurse. It was on a weekend and the physician on call was much more amenable to helping me out. He offered Tramadol (thirty 50 mg tabs, a synthetic and weaker narcotic to be taken 1 to two times every six hours). And, I continued using up to 6,000 mgs of acetaminophen per day, despite the danger of liver damage. Thankfully, by this time (the third week at home) normal daily pain had lessened quite a bit. The difference of having the Tramadol, where I had been stretching out the oxycone was very effective and helped tremendously at first. I had used Tramadol in the past and not gained much pain relief. But now it seemed to be doing the trick. 

I discovered that a recurring cough was due to a psychological response to being around a person I have a difficult time dealing with. When this person was around, my blood pressure also ran dangerously high and I experienced profuse sweating. Although the stress of dealing with this person had been recognizable before surgery, now, the psychosomatic response was much stronger. I don't know why, but apparently the phenomenon of anxiety, re-manifested as physical discomfort, is common after heart surgery for some people. Just a new thing to have to deal with. To rationally continue my treatment of normal chest pain and escape the deleterious psychosomatic effects of this other issue, I have simply been trying to avoid interacting with the person as much as possible while I heal up. I think I will be able to overcome the physical reactions more easily once the sternum is fully healed. At least then, developing the psychosomatic cough won't ALSO be an exercise in physical agony. 

As with most things, overcoming all of this is simply a matter of time. In IWALLK terms it is just another “long distance walk.” I endure it until I get to my destination. While time may “heal all wounds” conscious effort is the true key to controlling pain in all of its manifestations. As I said earlier, it is the mind that ultimately takes control. Only the mind can find the hallway to the shining Exit at the Pain Buffet. I am so thankful to only be stopping by there for appetizers this week; just passing through on my way to a new life. 

Knowing now the full extent of the struggle for finding relief, I have a fresh appreciation for the struggles of the chronically pain-afflicted. I genuinely pray for them and feel for them. I can truly say that what is left of my heart breaks for those who are trapped among the cold, rotting service trays, dirty dishes, unfair policies, and darkened tables of the Pain Buffet. 

When all substances are finally decriminalized and/or legalized, the taxes on their sales are redirected toward the treatment of abuse disorder for the rare 10% who need it, and rationality breaks through the prejudicial and purposefully blinding policies of pandering politicians – handing back the control of health decisions to patients and doctors and away from subsidy-seeking law enforcement agencies – not only will individuals find the relief they need, but society itself will be freed from an ignorance that has only served to unnecessarily amplify its own problems. I would love to live long enough to see a closed sign in the window of the Pain Buffet. But it will take more than the detailed recounting of my story. It will take YOUR acceptance and efforts too. 

Together we can close the place down for good!