Monthly Archives: May 2018

The Privilege of Self-Care

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A friend and colleague shared a tweet with me last week that pointed out a simple truth that there is a certain amount of privilege associated with self-care. In this case, it was the privilege of knowing you need care, what kind of care, and having the resources to do something about it.

“Why do I rally against the rhetoric of self help in academia? It isn’t because it doesn’t work for those with stress or mild anxiety or any other condition, it’s because it puts the responsibility to stay well and get better on those who are too unwell to participate.”

I’ve written before about self-care as capitalist plot, and it is. Capitalism doesn’t care all that much for individuals, save as how they can be leveraged to produce wealth for other individuals. Pushing us all to self-care is along the same lines of creating self-repairing, self-correcting machinery to reduce costs in producing widgets. After all, if a machine is self-repairing, it doesn’t need technicians and mechanics to support it.

Of course, there really is no argument (as far as I can tell you) that self-care is a personally good thing to do. It is definitely a private good and in your best interest. Self-care does take resources, it does take privilege. If nothing else, it takes the privilege to be able to stop and breathe, to stop activities that add no value or are harmful.

When one is suffering from depression, anxiety, chronic pain, or other disabling condition it is next to impossible to self-care your way to a better space. You need help identifying your situation, your needs, and a way to get those needs met. I certainly needed those things.  Having someone point out my depression, the way I was ignoring it, and what I could do about it, made all the difference. I still needed to act on that information, which I did, and I needed the resources (medical care, insurance, counseling) whcih I had. So I got better.

Unfortunately many people don’t have those resources, including a friend or colleague that helps them to identify their problem or needs. That’s why self-care is so often for those with privielege. We need to create systems where everybody has access to the tools, information, and support they need to perform self-care. We can’t just preach about it or write about it and tell people to just do good self-care.

In fact, I would make the point that good self-care is a collaborative effort since it relies on the support and/or input of others. For this reason, we should being about self-care of the community. How do we take care of all of us, by taking care of ourselves through taking care of others? It seems delightfully mutually supportive and cyclical. The only problem is that we would have to give up all the divisions among us that we love to cherish, shout about, and chew on in deep, dark thoughts that are really antithetical to good self-care.

 

 

 

 

It was nothing at all

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We didn’t really know each other, Melinda and I. She was a student worker in my father’s departmental office. A mutual friend was having a small birthday party at a local bar and that was where things began. We wound up dancing together until quite late. That first dance was to Heart’s “It was nothing at all.”

I would walk home every evening
Through the pyramids of light
I would feed myself from silence
Wash it down with empty nights

Then your innocent distractions
Hit me so hard
My emotional reaction
Caught me off guard

It was nothin’ at all (nothin’ at all)
Like anything I had felt before
And it was nothin’ at all (nothin’ at all)
Like I thought, no, it’s so much more

It wasn’t love at first sight, nor was it love at first dance. But something clicked that night, sometime between that dance and a conversation that ended about five in the morning. It grew quickly and, despite some rocky beginnings, has survived 32 years.

***

Monday I had the eighteenth MRI of my skull since December 31st, 2009. It has been almost exactly two years since the seventeenth. Fortunately, the remains of Bob the Tumor, appears to be stable and hopefully dead or dying, following surgery in 2010 and radiation in 2012.

When discovered, the tumor was about the size of a golf ball, choking the brain stem. How long it had been there is anyone’s guess. With a typical growth rate of of 1-2 millimeters per year and a size around 44mm , the minor mutation to the cell sheath in the meninges could have occurred between 22 and 44 years prior to discovery. Or longer. Or shorter.

It doesn’t really matter though. What does matter, or at least of interest, is that it was a tiny, infinitesimal thing, almost “nothing at all” that eventually changed everything for me.  Slowly and maybe inevitably, this thing grew inside my head, deep into the cerebellopontine angle alongside the brainstem. If the tumor had not extended along the vestibulocochlear nerve destroyed my hearing, we might not have known it until I fell into a coma and perhaps died.

From nothing back to nothing, almost.

***

Very shortly after my MRI (literally just a few minutes), I saw my neurosurgeon to get the results. (For a great many patients it is not this quick. Too often there is a period of weeks between the MRI and the consult. That’s a long time to ponder the possibility of growth. )  As with any most any medical appointment there is the taking of vital statistics and weighing.  It was pretty cool to see that I had lost exactly 100 pounds since my appointment two years ago.

Losing weight is a series of very small steps. The only big things involved are the decisions to commit to the process and anything you might give up permanently. (I went cold turkey on soda and few other things and haven’t looked back.) Every day is a series of small decisions, almost unnoticeably small, to stick with the program. Most of the changes in weight are likewise small. There’s a need to learn and understand the rhythms of one’s body and how it reacts to food and exercise that helps develop the patience for sustained weight-loss.

There’s a lot of “nothing at all” that seems to exist between occasions of notable progress in the process of losing weight. It’s all trying to do the right things, minimal cheating, and hoping you’ve maintained a daily calorie intake deficit. This is an act of faith and estimation. Faith placed in tools and the work of others and learning to estimate food quantities (unless you carry a scale everywhere) and calorie burn.

***

When I was recovering from surgery, a friend advised me to stop focusing (and dwelling) on the things I couldn’t do at the time, but all the hundreds of other things I could do. This was helpful advice, especially once I realized that most of things I couldn’t do were made up of small things. Movements that were small, seemingly inconsequential, and that I had never really been aware of before. I just had to work on the small things and perhaps the big things would happen.

It was the same thing when I was going to physical therapy last fall and I was performing facial movement exercises that focused on moving one or two muscles at a time. This was challenging. I never thought about how to sneer before, I just did it. However, trying to sneer on the left side was not happening. After many sessions of trying to activate  a dormant muscle, I still can’t sneer on the left, but I have movement and this movement leads greater plasticity (normalcy).

It’s the little things.

It was late one Friday
He pulled in outta the dark
He was tall and handsome
First she took his order, then she took his heart
They bought a house on the hillside
Where little feet soon would rock
Well from small things Mama, big things one day come

-Bruce Springsteen, From Small Things

***

We often tell each other,  “Don’t sweat the small stuff.” It’s good advice as far as it goes. Just don’t ignore the small stuff, pay attention to it. Every big thing starts with a little thing, a change, of something that was almost nothing. Kind of like the butterfly effect where the fluttering of a butterfly’s wings can ultimately lead to a tornado around the other side of the world. Or just the cumulative steps that cause you to end up somewhere else.