an autodidact meets a dilettante…

‘Rise above yourself and grasp the world’ Archimedes – attribution

Represent US and ‘US democracy’, part 1

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If there was one decision I would overrule, it would be ‘Citizens United.’ I think the notion that we have all the democracy that money can buy strays so far from what our democracy is supposed to be.

Ruth Bader Ginsburg

Leaving the weird awfulness of Covid-19 aside for a while, I must thank a good friend for sending this video my way. Jennifer Lawrence is an American actor none of whose films I’ve ever seen, but in this video she and Josh Silver, fellow member of the activist group Represent Us (with presumably a play on the US – and they’ve been making videos for years now), effectively focus on a problem of US politics I’ve largely neglected in my own analyses of the subject since the advent of the most recent incumbent in the white palace.


I’ve referred to it obliquely, for example when writing about the election cycle in that country, and my view that there’s at least one election too many – i.e. the presidential election. It all seems too much of an expenditure of time and energy, but I neglected to focus enough on the most insuperable problem – money.

So in this post I want to look at what Lawrence and Silver claim about the influence of money and wealthy lobbyists on government, especially federal government, and the corresponding lack of influence the relatively disadvantaged generally have, in spite of their vast numbers. Are there claims accurate?

l’ll try to fact check much of this – and their first claim isn’t directly about money, it’s the claim that the last two presidential candidates, Clinton and Trump, were ‘the least popular candidates since they began keeping track of such things’. Australia’s journalistic website The Conversation certainly confirms this about Trump. At election time, he ‘had the highest unfavorability rating in history, with over 61% of Americans having an “unfavorable” or “disapproving” view’. His victory, with fewer votes, says much about the electoral college system and how it favours less populated ‘red’ states, but I won’t go into that here. Clinton, though, was a ‘historically unpopular opponent’, with an unfavourable rating of 52%, the worst rating ever recorded for a losing candidate. So that checks out.

The next claim is that ‘only 4% of Americans have a great deal of confidence in Congress now.’ I imagine that the word ‘great’ is key here, as everything depends on framing. For example the question might be – how much confidence do you have in Congress? (a) no confidence (b) very little confidence (c) a fair amount of confidence (d) a great deal of confidence – or something similar. And how many constituents, anywhere, would say they have a great deal of confidence in their politicians, where there’s space to express skepticism? A quick check shows that the figure comes from a Gallup poll reported in The Atlantic back in 2014, and indeed it was a multiple choice question, but the most interesting/disturbing finding was that the attitude to Congress has suffered a massive downturn in recent decades, as shown by the graph below. So, unless there’s been an uptick in the last few years – and surely there hasn’t – Represent Us is right on this too.

The video next focuses on a Princeton study on ‘how public opinion influences the laws that Congress passes’. Represent Us presents this as a ‘thirty percent rule’. Any law has a 30% chance of being passed by Congress, regardless of its public support (from no support to complete support). The Princeton study concluded, apparently, that ‘the preferences of the average American appear to have only a minuscule, near-zero, statistically non-significant impact on public policy.’

So, the 2014 study, by two professors of politics and decision-making, Martin Gilens and Benjamin Page, is self-described as ‘tentative and preliminary’, but they are clear about their findings:

The central point that emerges from our research is that economic elites and organized groups representing business interests have substantial independent impacts on U.S. government policy, while mass-based interest groups and average citizens have little or no independent influence.

I’ve just read the study, and, unsurprisingly it’s a lot more nuanced, complex and at times dauntingly technical than the 12-minute video. For example it points out that policies advocated by cashed-up lobby groups may well benefit most of the public in spite of their lack of popular support. However, the economic elites, who have the most influence on Congress through financial, quid pro quo support, favour policies which are generally non-beneficial to the poorer, and far more numerous, sectors of the population. In fact, a lot of the findings remind me of passages in a very different text, Robert Sapolsky’s monumental book Behave, where he examines class-based behaviour (he calls it socio-economic status rather than class, coz we all know that the USA is a classless society haha). Take this example:

… a culture highly unequal in material resources is almost always also unequal in the ability to pull the strings of power, to have efficacy, to be visible. For example, as income inequality grows, the percentage of people who bother voting generally declines.

R Sapolsky, Behave, p292

As Sapolsky also points out, the super-rich, and their children, tend to move in the limited circle of their peers and so reinforce each other in seeking to maintain and enhance their lifestyles. The super-poor, meanwhile, are more often in a battle with each other (and not with the super-rich who are invisible to them) for resources, and tend not to trust government, since it is run by ‘them’. So the more economically unequal the nation, the more political power falls into the hands of the wealthy.

Anyway, returning to the video, the next claim is an odd one: ‘politicians are spending up to 70% of their time raising funds for re-election’. The term ‘up to 70%’ could actually mean anything from zero to 70%, so let’s take that with a pinch of salt. Another Represent Us website quotes former Democrat senator Tom Daschle: ‘a typical US senator spends two-thirds of the last two years of their term raising money’. I’m not sure if this is meant literally, but of course time spent isn’t the issue, rather money raised is the issue. The video goes on to make this interesting claim: ‘in order to win a seat in some races, you would have to raise $45,000 every day for six years to raise enough money to win’. I’m not sure how to fact-check such a claim, though ‘in some races’ could be a warning sign of some exaggeration or over-simplification. Then again, the idea of those kinds of dollars being involved in any electoral race is a sure sign of shonkiness. In any case the claim has to be seen in tandem with the next factoid presented, that ‘only .05% of Americans give more than $10,000 to politics’, which suggests that this tiny sector – the super-rich and wealthy special interest groups – are the funders of election campaigns, generally with agendas that the pollies are politely commanded to comply with – with the inevitable result for the increasingly disengaged majority.

So, whether these facts are precisely correct or not, it’s clear enough that money is poisoning democracy in the USA. As the video goes on to say, Americans are leaving the major parties in droves, and some 42% are registered as independent, rather than members of the duopoly of Republicans and Democrats. And since there are virtually no independent candidates, the quote from Sapolsky above becomes all the more relevant.

I’ve only looked at about a third of the video, but I’ll post this lot and present my take on the rest in my next post. Keep well!

Written by stewart henderson

March 30, 2020 at 2:43 pm

Covid-19: act quickly, test widely, maintain distance

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CECI N’EST PAS UN KIT DE TEST

So Covid-19 is the inescapable pandemic, the great test of administrations worldwide. We’re beyond blaming China for inflicting this upon the world, though this shouldn’t be forgotten, as mistakes need to be remedied. But now we’re looking elsewhere for praise and blame. Few people are keen to praise the Chinese government for its methods, however effective they might be. They’re looking to more humane governments, those that have achieved similar results without the brutality.


A much-discussed essay from Imperial College London compares suppression with mitigation, and favours suppression, and this is proving controversial, as others say it’s overly pessimistic, citing apparent success in flattening the curve in South Korea, for example. Of course there’s the difficulty of knowing whether reported data is reliable, whether testing is thorough enough and so forth. This article from The Conversation looks at South Korea’s success and suggests it may be as much due to its surveillance technology regime as to its effective virus testing program. Other countries, such as Taiwan and Singapore, have also been very successful, apparently, though with a much smaller case load. Another enigma appears to be India. It has been praised for shutting its borders early, but surely there would be a difficulty in obtaining reliable figures in such a diverse patchwork of a nation. Still, if we take its reported figures on face value, it has been an outstanding success story, so far.
South Korea’s success has much to do with its sophisticated biotech industry (something we in Australia can also boast of), which can produce tests quickly. It also has a well-developed healthcare system, apparently. It has done more testing than any country, other than China, so its figures are likely to be more reliable. But it can also track contacts of Covid-19 sufferers through debit and credit cards and mobile phones (the country is at the top of per capita users of these items). The country also employs CCTV surveillance more than just about any other country in the world, and this is mostly acceptable to its citizenry. My own conversations tell me that such surveillance would cause much greater concern here.

So the pandemic will continue to be combated with a variety of methods by different countries, all looking to others to see what works and to modify working methods to suit their own people. Keep alert for success stories and analyse them, see if they can be replicated. Italy appears to be a disaster, but not everywhere. In the northern town of Vo, where the first Italian Covid-19 death was reported, health authorities managed to lock down and test all 3000 of its residents at the outset, and found a 3% infection rate. The infected, most of whom displayed no symptoms, were quarantined, and a later large-scale test found the rate had been reduced to less than 0.5%. Of course, this is a small town, but the lessons are obvious. Test widely and act swiftly, and make sure you’re prepared for this sort of situation, unlike the USA, where federal neglect under the wanker in the white palace has virtually eviscerated its CDC. The CDC’s failure to provide test kits to state public health labs at the start of the outbreak has massively hampered the ability to isolate and trace contacts of the infected, so important during the early stages. Labs around the country are still struggling to fill the void, while the wanker engages in the standard down-playing, over-promising and blame-shifting that’s inherent to him.


Here in Australia we’re ranked 21st in the number of cases, not great for a sparsely populated island nation, far from the epicentre, though our connections with China, and our slowness in shutting down travel from that country, is the likely explanation. The good news is that we’ve recorded only seven deaths from a little over a thousand cases so far. The bad news is that the curve isn’t flattening, with more than a hundred new cases recorded in the last 24 hours. Stop press: make that more than 200, and Australia has jumped to 19th in the number of cases, though still only 7 deaths thankfully. I’ve just listened to a press conference by our Prime Minister and Chief Medical Officer announcing closures to pubs, restaurants, cinemas and cafes for the foreseeable. Schools, however, are to remain open, with everyone expected to follow distance rules of four square metres. This is all extremely unnerving. I’ve been asked to teach tomorrow, with different classes starting at different times to prevent crowding on arrival and departure. I’ve agreed to do it, though I’m over sixty with a pre-existing bronchial condition (but it’s more the over seventies that are at risk). Much of the questioning at the press conference was about the school situation, with states such as Victoria not apparently being aligned with the federal government on whether they should remain open. It may be difficult to maintain the four square rule in a relatively dynamic, interactive classroom, and then there’s the question of virus spread by people who haven’t been tested and show no symptoms. Our students have already been here for a while, and I’m presuming, without much knowledge, that infectiousness is greatest in the early stages of contracting the virus. There are also rumours, mentioned in the press conference, that the young may be ‘super-spreaders’. The Chief Medical Officer claimed that there was no evidence to this effect, and I note that the term is rather frowned upon as ‘unscientific’, but without more widespread testing we really don’t know what, or who, we’re dealing with when we enter a classroom.


Meanwhile, just in the past 24 hours there’s been a spike of cases here in South Australia, all from people recently returned from overseas and interstate. Of course, these are the people who would be tested… And, Australia has now jumped to 16th in the world for number of cases, but the death toll remans the same – in fact we have the lowest mortality rate of all the top twenty countries, according to worldometer, but I’m personally a bit skeptical of these figures.
May we live in interesting times…?

Written by stewart henderson

March 23, 2020 at 11:09 pm

Posted in behaviour, covid19

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gods, science and explanation

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If you think that it would be impossible to improve upon the Ten Commandments as a statement of morality, you really owe it to yourself to read some other scriptures. Once again, we need look no further than the Jains: Mahavira, the Jain patriarch, surpassed the morality of the Bible with a single sentence: ‘Do not injure, abuse, oppress, enslave, insult, torment, torture, or kill any creature or living being.’ Imagine how different our world might be if the Bible contained this as its central precept.

Sam Harris, Letter to a christian nation

Reading David Deutsch’s The beginning of infinity, together with a collection of Stephen Jay Gould’s essays, Dinosaur in a haystack, has reminded me of my critique of Gould’s bad NOMA argument, which I reread lately. So here’s a revisiting and a development of that critique.
Put very simply, Gould argued that religion was about moral and spiritual matters, and that science was about causes and effects in the natural world, and that these spheres of interest didn’t overlap, so co-existence was not only entirely possible but mutually beneficial.

In his argument, I noted, Gould generally avoided mentioning gods, or God. It seems to me now, that this is more of a problem than I thought at the time, because religions are all about gods. While I don’t want to be hard and fast about this, religions really don’t exist without gods. In that sense, you might call Buddhism a spiritual belief system or worldview or discipline, but it isn’t a religion. It doesn’t use gods to explain stuff. And Confucianism even less so. Certainly in earlier times, in a more god-besotted world, Buddhism and even Confucianism were associated with or could be easily assimilated with local deities in China, Korea and Japan, and the world of morality was generally associated with portents and god-induced ‘disasters’, but that was to be expected in a pre-scientific climate, which prevailed globally for most of human history.

This is the point. For century upon century, gods, their behaviour, powers and attitudes or natures, were the explanations for war, famine, disease and the everyday accidents that humans suffered from. Even as some medical and other knowledge developed, the will of the gods was always there as a background explanation for the otherwise inexplicable. And so it shouldn’t be surprising, in a world teeming with god-explanations, that the pioneers of more earthly, measurable and testable explanations for phenomena still clung to this background of god-explanations for so much of what they saw around them – the birds in the sky, the food that sprang from the ground or hung from the trees, the life-giving rain, the failed harvests, the floods, the plagues, the invasions and so on.

Nowadays, what we call science can provide better explanations in every area we can think of than do god-explanations, and this is a major blow to religion and its relevance in the modern world. I would describe it as a death-blow. Indeed gods aren’t just bad explanations, they’re not really explanations at all. Why gods, after all? What are they, and where do they come from? No coherent explanation can be offered for them. Of course the obvious answer is that they come from the human imagination, as is evidenced by the human qualities they display – the beauty of the love-goddess, the long-bearded father-god, the thunderous dyspepsia of the war-god and so forth – but such an explanation is anathema to religion, as it collapses the house of cards. So an attempt is made to divert attention from inquiring into the ineluctable mystery of the god’s existence – sometimes by making such inquiries a kind of sacrilegious abomination – and to focus more on the god’s commandments. This is a move made by many a staunch Catholic.

I’ve heard such people say that the ten commandments of the Old Testament are clearly the basis of all our laws and morality. I’d like to have a look at them, particularly in terms of explanation. As young children, we’re often given commands – do this, don’t do that – by our parents. These commands generally have an explanation supporting them, which we learn later. But the explanations are essential, and commands without effective explanations to support them are surely a form of tyranny – at least that’s how I see it.
So let’s have a look at these commandments, which are so essential to ‘western’ or ‘civilised’ morality, according to some. I’ve put them in my own words.

  • 1. I’m your god, you mustn’t have other gods before me.
    This has nothing whatever to do with morality as far as I can see. This god says elsewhere that he’s a jealous god, and this is further proof. Catholics gloss this commandment as a commandment against idolatry, but that’s highly problematic because it makes the enormous assumption that the god called God is not an idol. If he’s saying ‘I’m the true god, all the others are fake’, he needs to provide proof. He doesn’t – and presumably makes the arrogant claim that he doesn’t need to.
  • 2. You mustn’t take my name in vain.
    So what is this god’s name? God, apparently. It’s like a marketing ploy, as if MacDonalds got to change their name to Hamburger and could take action against anyone else who used the name. In reality the god now called God was an amalgam of Hittite and Armenian gods, forged into a monotheistic being by elites of the region somewhere around the 7th century BCE. The idea of the commandment is that you should speak his name respectfully. Why? Because he’s God. The only way to avoid a circular argument here is to provide proof of this god’s existence, which hasn’t been done and can’t be done. There’s no morality on display here.
  • 3. The sabbath day should be kept holy.
  • This is fairly arbitrary, the word coming from the Hebrew sabbat, meaning rest, and it’s based on God’s rest day, as he created the universe or multiverse or whatever in six days and rested on the Saturday, according to Judaic tradition, but Christians arbitrarily changed the day to Sunday. Of course no educated person today thinks the world, universe, or whatever, was created in a week, whatever you define a week as, by an ethereal being. Again, this could only have moral effect if you believe in this creation story and the god at the centre of it (and if you believe the god is egotistical enough to want to be eternally remembered and acknowledged in this way).
  • 4. Honour your parents.
  • As a heuristic, this makes sense, but it is not a given. Some parents kill their children, others do irreparable damage to them. The vast majority, of course, don’t. This is a matter of individual cases and analyses. The complexity of parent-child relations is dealt with most profoundly by Andrew Solomon in his great book Far from the tree. I would refer everyone to that book as a response to the fourth commandment.
  • 5. You mustn’t kill.
  • This again is too vague, as it doesn’t deal with self-defence and other exculpating circumstances. It’s also fairly commonplace, and common-sense. It’s easy to find supporting explanations. Nobody needed this commandment to create laws regarding murder and unlawful death.
  • 6. You mustn’t commit adultery.
  • A lot can be said here. At the time that these commandments first appeared, and for a long time afterwards, women and girls were treated as chattels and very often married off against their will, sometimes as children, to men twice or thrice their age. Considering such a context, and considering that contraception was essentially non-existent in those days, adultery was generally treated differently depending on wealth, social status and gender. There might have been an explanation for the law of adultery, but it probably had more to do with property and the status of offspring than morality per se.
  • 7. Don’t steal
  • The concept of private property would have emerged slowly, and would have been interdependent on other cultural developments in the move from horizontally to more vertically based cultural systems. Even so, it’s unlikely that a prohibition on stealing would’ve been novel when this commandment was formulated.
  • 8. Don’t lie
  • the telling of lies to advantage oneself and disadvantage others would have been a problem at least since effective languages developed, and we have little evidence as to how long ago that happened. We certainly know it was long before the 6th or 7th centuries BCE, so there’s nothing new here. Again, though, the commandment is too vague to be particularly effective.
  • 9. Don’t covet (lust after) your neighbour’s wife
  • These last two commandments are about thoughts, which makes them particularly ineffectual. They might be interpreted as advice, which would leave us with fewer commandments to criticise, but even as advice they seem like so much pissing into the wind. And of course the fact that wives and not husbands are singled out is an indication of the particularism of the patriarchal society this commandment addresses.
  • 10. Don’t covet (hanker after) your neighbour’s goods.
  • Again, hardly a profound or memorable commandment, and barely relevant to today’s society. If you’re impressed by your neighbour’s car, for example, you might ask her about it, check out its performance and decide to get something similar yourself. What’s the big deal?

I’ve spent too much time on this, but I simply wanted to point out that, while gods are what religion is all about, they are, or were, also used as explanations. That’s in fact what they were for. And a ‘commandment’ is simply an explanation once removed, because they represent the god’s will. The explanation, therefore, for bad tidings or bad karma or whatever, becomes failure to follow the will and the commandments of some particular god or other.

Nowadays we have better explanations, based on what we know of human psychology and neurophysiology, and of how we work together in societies, as the most socially constructed mammals on the planet. We also know much more about how the physical world works, which has resulted in technological developments of increasing reach and sophistication. The idea that knowing so much more about what we are has no relationship to what we should do – the moral sphere – has always struck me as preposterous. This old is-ought separation was key to Gould’s NOMA thesis. But it’s not only that science’s increasingly far-reaching accounts of ourselves and the universe we live in is essential to our decisions about what we should do. It’s also true that religion keeps trying to tell us what we are. And its account s just don’t stack up, from the broadest scientific perspective. It just fails comprehensively as an explanation.

Written by stewart henderson

March 20, 2020 at 2:58 pm

My current health condition 3: nerves

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I’ve been to see a physiotherapist/sports medicine specialist, on the advice of a couple of people, and I’m happy with the result. It won’t mean an immediate cure, but the session has provided me with hope and a pathway to recovery.

Today and yesterday, the pain has been fairly minimal, after an excess of pain the day before. It seems to be about managing the medication.
So, to the physio. I described my situation in minute detail, describing as best I could the type of pain I felt, its sudden onset, how it responds to head movements and so forth. He very quickly conjectured that it was a nerve problem, which in fact had been my first intuition before I began researching the problem. He described the ‘queerness’ of nerve injury, or nerve impingement as it’s often termed – how damage in one place can be felt in another seemingly unrelated region. Interestingly, it was my description of how, since this condition has struck me, I’ve had difficulty moving my head back (this causing my shoulder pain to increase), and so not being able to gargle with mouthwash – which I do because of my bronchiectasis – it was this description which made him feel more certain that it was a nerve problem. He could be wrong but I think he’s right.

He did a lot of physical manipulation of the shoulder region and gave me advice. Keep up the medication, maintain activity of the shoulder and arm regions – not too much but not too little – and keep the area warm. He gave me some shoulder exercises to do, and assured me things would come good in time. I’ll revisit him next week.
Now, on this concept of impingement. It’s a term that comes up in the literature, and it was used by the physiotherapist today, so I asked him about it. He obliged by giving an explanation that was complex and difficult to follow, much like the material I’ve been reading online about the subject. So I’ll have a go at explaining it to myself.
Nerve impingement is one term among many (e.g pinched nerve, nerve compression, nerve entrapment), which indicates the trickiness of the condition and its description. In my case the suprascapular nerve is probably involved. As Wikipedia puts it ‘the nerve passes across the posterior triangle of the neck parallel to the inferior belly of the omohyoid muscle and deep to the trapezius muscle.’ I don’t know exactly what this means, but it seems to explain the pain at the back of my neck, left side, when I throw my head back.

The posterior triangle of the neck is a technical term with its own Wikipedia page. Here’s an image of it. As can be seen, it connects the omohyoid muscle and the massive trapezius which goes well down the back.
So nerve impingement/compression/entrapment is what it implies – something is impinging on the nerve, entrapping it, compressing it, pinching it. It could be bones, muscles, tendons, ligaments, cartilege, and that just about exhausts the possibilities. Carpal tunnel syndrome, for example, generally involves a pinched nerve in the wrist. The causes of course, are various. It could be a particular injury – but I can’t trace my own sudden onset to a particular injury (which doesn’t mean that no injury occurred) – or physical stress from repetitive work or sports activity, or some rheumatoid problem (which presumably would’ve shown up as some sign of inflammation, and I’ve never shown any signs of rheumatism) – or obesity.

The possibility that this was caused by lawn bowling remains real, if remote. Fascinatingly, when I told the physiotherapist that the only sports activity I’d taken up in recent times was lawn bowling, he asked me if I played at Walkerville – it turns out that he recognised me as he played in the competitions there too – out team had thrashed his only a few weeks ago! He agreed that bowling as a cause seemed unlikely – but being a bowler himself, he would say that, wouldn’t he?

But whatever the cause – and I won’t be bowling again for a while, if ever – the diagnosis and cure are the things, and it’s amazing what a seemingly effective diagnosis can do to calm the – nerves! I feel I can cope much better now, and I’ve had the humbling experience of knowing what severe pain is like. This is important as I’ve tended to be dismissive of the pain of others, with thoughts of ‘low pain threshold’ and ‘get over it’. So, it’s a lesson.

I’ll be returning to the physiotherapist next week, hopefully for the last time. His feeling was that just one more session would be enough, that if I simply followed the light exercise regime he suggested, things would come good. The pain has risen and fallen since then, but there’s been no relapse into anything agonising. I worked at Eynesbury yesterday, a relief day, but hopefully there won’t be any work for a while. In any case Covid-19 means we probably won’t be getting many, if any, students coming in from overseas over the next few months.

Of course, it’s not all back to normal, though I’ll try to get back to regular reading, writing and the like. Here’s a final quote from the Mayo Clinic on my situation:

If a nerve is pinched for only a short time, there’s usually no permanent damage. Once the pressure is relieved, nerve function returns to normal. However, if the pressure continues, chronic pain and permanent nerve damage can occur.

We’ll have to wait and see.

References

https://www.mayoclinic.org/diseases-conditions/pinched-nerve/symptoms-causes/syc-20354746

https://www.healthline.com/health/nerve-compression-syndrome

https://orthoinfo.aaos.org/en/diseases–conditions/cervical-radiculopathy-pinched-nerve/

https://en.wikipedia.org/wiki/Suprascapular_nerve

Written by stewart henderson

March 18, 2020 at 2:02 pm

My current health condition 2: searching for a diagnosis

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It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

Julius Caesar (and I’m willing to volunteer)

I haven’t been much in the mood for writing. You could say I’m feeing sorry for myself, or indulging in the pain I’m experiencing, but truth to tell, my current condition doesn’t make it so easy to ‘rise above myself and grasp the world’. I’m hoping at least to rise above my own pain and grasp the world of pain in general! But before I look at the ‘philosophy of pain’ I should update my situation.
The pain – shooting down from the left shoulder – first became acute on February 29. On that Saturday I arrived in an ambulance at Royal Adelaide Hospital, was examined, questioned and released without a diagnosis. Panadol, administered by the paramedic in the ambulance, had relieved the worst of the pain. I bought over the counter medication, ibuprofen and paracetamol, and using them at the upper limit of, and perhaps beyond, what was recommended, I was able to work at Eynesbury College on the following Monday and Tuesday. On Wednesday I visited my GP. I was referred to St Andrews Hospital for an ultrasound and an x-ray. The GP told me that if the pain subsisted or worsened the hospital could give me a corticosteroid injection in the shoulder, which he thought would do the trick, painwise.

Meanwhile I was doing my own research. It seemed that bicipital or biceps tendinitis was the best fit. There was also bursitis and some kind of rotator cuff damage. I couldn’t think of an obvious cause, the only ‘different’ activity I’d been engaging in was lawn bowling, generally associated with geriatrics and hardly recognised as strenuous activity. However, when Sarah, who was also doing some research, noted that one line of enquiry led to ‘dangers and injuries from lawn bowling’, I felt less dismissive.

My appointment at St Andrews was for Friday (March 6), but on Thursday a felt increase in pain had me asking Sarah to ring the GP for stronger medication. I was prescribed ibuprofen plus codeine, which I started taking, again pushing beyond the recommended limits. However, my subjective sense told me that paracetamol was more effective than ibuprofen. Yet ibuprofen was an anti-inflammatory, paracetamol was not. It was all very confusing. Did I have pain without inflammation? How could this be?

I was driven to St Andrews hospital next morning, where I was given, first an X-ray, then an ultrasound test. This was a first for me, and I was able to watch the screen as the young woman administering the test slowly moved the scanner across my shoulder region. From her silent response and my own observation of a kind of softly rolling ocean of muscle disappearing into the distance, I got the strong impression that there was nothing untoward, no sign of damage or dysfunction.

Meanwhile, the pain continued, together with difficulty sleeping, and a general lethargy, which might just be a sort of depression at the sense of restricted movement. I noted that I felt physically at my best when lying still, on the sofa or my bed. Just getting up resulted in shooting pains. Reading, holding a book, was a pain. All of this was on my left side, and I’m very left-handed.

And so it went, until something dramatic happened, I think it was on Sunday (March 8). I experienced severe constipation, certainly unlike anything I’d ever experienced before, and I won’t go into the shitty details, though it did make me think of my mortality (as has this experience of pain in general). How many people have died on the toilet seat? A dirty little secret, no doubt. In any case, I recovered, and, upon further desperate research (and noting that, before this bout, I hadn’t done a ‘number two’ for days – how had I missed that?), I dropped the ibuprofen plus codeine medication and went back to paracetamol.
I work part-time at Eynesbury College, currently two days a week (Monday and Tuesday), barely enough to live on, as a teacher of academic English to foreign students. It’s the most poorly paid job in the teaching profession. I’m paid as a casual, and work from five-week contract to five-week contract. It’s anything but ideal. For example during this current contract, which ends tomorrow (Friday), there were two public holiday Mondays, for which I wasn’t paid. I was offered another five-week contract starting next week, but I’ve made a decision to decline the offer, hoping to get on top of this pain situation once and for all.

I won’t go into my parlous financial situation, but it’s important due to my status vis a vis subsidised health care. More about that anon.

So I worked on Tuesday, and it was something of a struggle. Yesterday (Wednesday March 11) I returned to my GP and received the report from St Andrews Hospital. So I’ll now present the findings together with my comments.

X-ray and ultrasound left shoulder with subacromial bursal injection

subacromial bursitis has to do with inflammation of the bursa that separates the upper surface of the supraspinatus tendon (one of the rotator cuff set of tendons) from the overlying coraco-acromial ligament, the acromion, and the coracoid. To be explored further. A bursa, or synovial bursa, is a fluid-filled sac which cushions connections between bones, tendons, ligaments etc in joints.

X-ray – no bony injury. Alignment is normal. Subacromial space is preserved. No subacromial calcification.

Nothing to see here.

ultrasound- biceps tendon intact. No fluid in the sheath. The tendon does not sublux during internal/external rotation

Nothing again. Subluxation is a partial or incomplete dislocation of a joint or organ.

supraspinatus and other rotator cuff tendons are intact. No tear or tendinopathy. The subacromial bursa does not appear thickened and no bursal drag with abduction is identified.

So there are four rotator cuff tendons or muscles (not too sure of the difference); supraspinatus, infraspinatus, teres minor and subscapularis. The subacromial bursa is as described above.

The AC joint is normal in appearance and remained stable during forward flexion.

This is the acromioclavicular joint, at the top of the shoulder. It feels to me that the pain comes from ‘inside’ and lower than the shoulder, but it’s actually difficult to locate precisely. It may be a problem with the acromion, however. Or the Glenoid cavity or labrum. It may be a SLAP lesion (symptoms include ‘trouble localising a specific point of pain’. SLAP stands for ‘superior labrum, anterior to posterior’.

I’ll no doubt have to see a specialist, and the worry now is money

Written by stewart henderson

March 12, 2020 at 1:59 pm

My current health condition 1: it’s bizarre

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I can bear any pain as long as it has meaning

Haruki Murakami

stuff to learn about

I haven’t written for a while because I have a new health problem which flared up last Saturday, February 29, 2020. I had been feeling mild pain in my shoulder and I was lying on my bed reading when I tried to get up. Shooting pain from my shoulder down my left arm was so excruciating that I fell back on the bed and and lay down for a while before trying to get up again. Again I couldn’t get up because of the pain. I called for help but even with two of us it was difficult. I may have had a panic attack and exaggerated the pain of rising – I was gasping a lot. To cut a long story short Sarah called an ambulance (and the paramedic got me into a sitting position easily enough). I spent the next few hours in emergency at the Royal Adelaide Hospital.

Due to being given Panadol in the ambulance, and a long wait in reception while the painkiller took effect, by the time the friendly, efficient and strikingly beautiful (oh dear) young intern saw me, the pain, my only symptom, had much reduced. She found that, yes, I could move my arm above my shoulder, flex my elbow and my wrist, and no, I couldn’t precisely describe the nature or location of the pain. She checked my arm for swelling or redness (none), and asked about any recent history of injury to the region (none). I was beginning to feel like a fraud, a malingerer, a milquetoast.

So after some more prodding and questioning and advice from higher authorities, I was released with a report for my local doctor.

I’m very left-handed, so this left arm pain is quite a problem for me. I was due to work on the Monday and I needed some pain relief. It would have to be over the counter at first. The report’s only solid conclusion was ‘skeletal-muscular pain’. Since I needed to work on Monday and Tuesday I could only get to the GP on Wednesday. So on Sunday I started doing what research I could. I’ve never taken regular medication for anything, and I’ve never experienced regular pain like this. The only over-the-counter treatments for pain are ibuprofen and paracetamol as far as I know. Only ibuprofens is an anti-inflammatory. Paracetamol works on pain centres in the brain. Which one would work best? Was it all in my mind? But don’t we always feel pain via the brain? Isn’t that how the nervous system works?

I obtained both medicines. Over the next day or so I experimented with both, singly and in combination, and I got through Monday and Tuesday’s work. The pain never went completely away, though the teaching days, when I had to concentrate on and interact with my students and other teachers, helped to distract me from it, which gave me that guilty ‘it’s all in the mind’ feeling.

Even so, on Wednesday (March 4), the pain came roaring back. My subjective sense told me that the paracetamol was much more effective than the ibuprofen, another surprise. I visited my GP, who smiled at the hospital report, saying, ‘yes, they wanted you out of there as soon as possible – they’re there for acute, intensive care stuff, it’s understandable – a GP can refer you to a specialist, and we can go from there’. So he filled out a referral form for St Andrews Hospital, for an x-ray and an ultrascan. I rang them and organised an appointment, for Friday, March 6 at 11am.

I was still in pain, though. The OTC medication had reduced the pain to more bearable levels, but I still hadn’t worked out which worked best. Unlike me, Sarah was on many medications, for pain and other problems, including Prodeine (paracetamol plus codeine) and a set of tablets which combined paracetamol and caffeine. I was taking the tabs at the upper level of what was recommended, and beyond. I was trying to monitor the pain, what it felt like. It was always a low-level throbbing, which increased and became a shooting pain if I used the arm too much. It was a strange delayed pain – I would engage in a flurry of physical activity, such as preparing a quick meal, and then lie down, knowing that the pain would rise up as a result of the activity, then slowly subside. I had difficulty sleeping, and I dreaded dressing myself in the morning. Typing this is giving me an ache, and I’m experimenting with dictation – I find the Apple dictation system a pain (mentally speaking). I have to learn more about how to use it effectively.

Stupidly, I hadn’t asked my GP about stronger prescription medication. The day after the consult (Thursday, March 5) I had Sarah ring the surgery – I was experiencing bouts of serious pain, and was finding it hard to track what medication was working, or not. The doctor wrote a prescription, which Sarah collected and had made out at the pharmacy around the corner. It was for ibuprofen (200mg) and codeine phosphate hemihydrate (12.8mg). I was skeptical about the efficacy of ibuprofen, and I had been researching anti-inflammatories, and inflammation generally.

What, exactly, is inflammation? There are, supposedly, five signs of it, remembered under the acronym PRISH – pain, redness, immobility, swelling and heat. My only symptom was pain. There was certainly no redness or swelling. Immobility wasn’t a real problem either. I could move my arm above the shoulder, I could flex my elbow, etc, but some pain would come afterwards. Heat wasn’t something I could measure, but it didn’t seem an issue. Only pain. And I hadn’t pinpointed any cause of all this. I remembered what I’d said, quite often (or at least I thought I did – maybe I was mostly saying it to myself) to the intern at emergency: ‘It’s bizarre!’

Anyway, I’ll wind up this piece, and start on a new one, dealing with my time at St Andrews Hospital, the x-ray and the ultrasound.

Written by stewart henderson

March 8, 2020 at 12:43 pm

the autodidact story 1: family and authority

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When I was young I was somewhat troubled about myself. I was unhappy at home, I hated school, I felt I had no-one to talk to, and my only solace was the ‘rich inner life’ that, much later, I read about in an essay by the philosopher Hilary Putnam. That’s to say, he wrote an essay in which he happened to mention that some outwardly nondescript people might have cultivated a rich inner life, or words to that effect, and this fairly mundane observation was the only thing I took from Putnam’s essay.

I had a difficult time with friendship, and still do. On my birthday – I was probably fourteen – I received a card from another boy I knew well. It read ‘to my best friend ever’. I read it with shock. It made me feel somehow ashamed and miserable. I felt that this friend of mine was deluded, and I’d been the cause of his delusion. Perhaps there was some arrogance in this – I felt that my ‘rich inner life’ was almost completely hidden from him, and everyone else, so how could he think he knew me well enough to consider me his BFF? However, when he left for England with his family a few months later I felt more alone than ever. 

I’ve never felt seriously suicidal, but I do recall a particular moment, when I thought, ‘this is who I am – a loner. I have to learn to live with it’. I cried myself to sleep, and went on. 

Of course, all autobiographies, whether short or long, are mostly lies, beautiful or otherwise, so don’t take any of this too seriously. My parents didn’t get on too well, to put it mildly, and my siblings were – rivals. We lived in one of the most thoroughly working-class regions of Australia, in the newly created town of Elizabeth, built around the manufactory of holden cars, now deceased. My father worked there for a brief time, but he didn’t like working in factories, and I don’t blame him, having worked in quite a few myself. Unfortunately he couldn’t think of anything else to do, so he didn’t do anything much, and my mother was the nagging, harried breadwinner. My relationship with both of them during my teen years could fairly be described as toxic.

We did have books however. Encyclopedias, classics, and surprisingly modern fare, especially in the new feminist line, such as The female eunuch, Patriarchal attitudes, The feminine mystiquue and The second sex. I don’t know where all these books came from, they just always seemed to be there. My mother insisted on getting us to the library regularly, for which I’ll always be grateful, but I rarely saw her reading anything. She had a higher-up job in the nursing profession and when she got home she’d always flip the TV from the ABC to her favourite sit-coms, I love Lucy or The Dick Van Dike show. As for my father, I often wondered if he knew how to read. But these people bestowed upon me their genes, more or less equally, and that was a source of wonder. Was I smart?

We had come to Australia as ten pound migrants, and I had flickering memories of the boat trip – a camel train on the banks of the Suez, being saved from drowning in the ship’s pool, sitting with a group of kids while my mother, seconded as an educator, taught us spelling or something.  

Education. I became a teenager in 1969. It was a fantastic time for music, and the culture that came with it. I looked out the window at my brother and his friends and they were all wearing levis and it looked so cool. My older siblings were buying records – the Beatles, the Kinks, the Stones, and some now-embarrassing singles like ‘Little Arrows’ by Leapy Lee. Not long afterwards came Dylan and Cohen and I loved all that cool verbiage. Was I smart? I didn’t like school. I couldn’t talk to the teachers like other kids. I didn’t like the inequality, that they might know more than me. I didn’t like being told what to do. I liked to read, to learn stuff in my own way. I didn’t have an imaginary friend exactly, but I was always talking and arguing in my head, and felt the lack of the real thing.  

One day I was somehow invited to some kid’s house whose older sister was visiting from university. Did she live in the university? There was a crowd of kids and I could just see glimpses of the girl-woman through arms and legs. She was sitting on a stool as on a pedestal and she was slim and pretty with neat blonde hair and lipstick and a neat plaid skirt and heels, and I was shocked at this first ever sight of a university student. They were supposed to wear jeans and sandals and tie-dyed t-shirts and be beautifully scruffy and hairy. Disappointing.

Anyway, I left school because I was always in trouble for not doing my homework, inter alia, and I had horrible fights with my mother when she wasn’t having horrible fights with my father, and my father had fist fights with me, which wasn’t much fun as he’d been a boxer in his past and I could see him eyeing me for maximum damage with his dukes up. I would stay at friends’ houses here and there, and I got my first job on an assembly line making Wilkins Servis washing machines. The one shown is of course a much earlier model than the ones I tended to stuff up when I worked there.     

And so my first experience of formal education was botched, and maybe I should blame myself, I don’t know. I continued to read of course, and to argue with myself. A rich inner life.

I read novels, mostly, in those days. I developed an obsession with Thomas Hardy. This was in my fifteenth year, I think. The Return of the Native was my first, and I think I read every single novel except A Laodicean, which critics said was his worst. I wanted to read it, for completeness, like Two Gentlemen of Verona, which I did read. I also wanted to know why it was considered so bad. I loved Thomas Hardy, he was so kind, it seemed to me, and so sad somehow.

(to be continued)

Written by stewart henderson

February 28, 2020 at 7:30 pm