The Malingering

The Malingering

She is 48 years of age and pain has been her constant companion for over two decades now. Perthes Disease has destroyed both her hips and the degenerative scoliosis that set in probably a decade ago is only making each day more difficult and painful for her.
With her bag full of investigations, previous prescriptions and treatment records she met me in my OPD about 2 months ago.

“You don't need to suffer with this, I could replace both your hips and if the need be correct the scoliosis later on with another surgery” I exclaimed instantaneously amidst a partially completed turn of my chair towards the x ray view box with x ray still in my hands and the view box still awaiting the completion of remaining 60 degrees or so of my turns arc.

Too quick and too direct ………….. that’s what it was…….I would realize an instant later about my response ……..

As I gradually lowered the x ray film, the barrier between my eyes and hers, a woebegone air like an ill halo surrounded her ………. My words had struck like a calamity it seemed.

“Wouldn’t you like to go through these reports first” she spoke after a poignant silence.
“I don’t have to lady …… infact perthes was my top differential diagnosis the moment you walked into my OPD, seeing you from a distance of 50 meters, forget even these x rays …….your gait speaks louder than these reports …. And just like any other doctor I despise distrust…..” but thankfully the larynx is not directly connected with the mind. The frontal lobes of brain intervened with their social sensibilities and none of all this was ever verbalized.
Having given into the social sensibilities I simulated a smile and politely undertook the masquerade of going through the heap of papers wearing a contemplative look.
“Hmmmmmmmnnn …….so please tell me what brings you here?”, I asked, having completely exhausted myself with the farce of going through unnecessary reports and continuing to feign to go through them with my head still buried within them.
Infused with the satisfaction of my sham attention to her records the lady began speaking. Most of it was irrelevant leave alone insignificant and it continued for a while until all my pent up irritation blurted out as “but why are you here now?”.
Was it the tone or the forcefulness of the prohibitive dam of patience giving way I would never know but it had worked. These words had halted the seemingly unending train of her conversation.
“To be treated of course” she said defensively.
“And I have explained it to you already……”
“So let us discuss only what’s relevant in that regards” I continued
“But I don’t want to get operated” she said …….and I softened immediately because I could hear “I cannot afford to get operated, I am too afraid to get operated, there is too much at hand in my current life situation etc etc …..” from behind those words.

“Pain relief that’s what you are here for” (and that’s not treatment by the way)
An invisible yes was palpably present even in its auditory absence. A cocktail regime of pain relief was tailor made as per her requirements and she left.
A fortnight later she arrived in the OPD for follow-up, visibly better than the previous visit.
“So how are you now?” I made a cheerful but redundant remark, I thought (she obviously was better)
And off went the train of endless ramblings, obviously confused I looked at her husband, who had been desperately waiting for an eye contact (I now realized), who instantaneously falsified all her claims in a moment of eye roll and gesture.
“But are you okay as long as you take the medicines?” I randomly interrupted at some juncture.
“Yes I am” probably it was the sudden and unexpected arrival of the question amidst the heavy traffic of monologue that brought forth such a short and truthful reply, at least at that instant.
Of course she followed it up with various complaints about the side effects she was experiencing with these medicines (none of which have ever been noted in any text of medical knowledge anywhere for those drugs)………. And how her life now is even more miserable than before; though without pain but with these side effects now.
“These medicines are not the cause of the symptoms you are experiencing, they don’t have any such side effect profile” with my patience thinned out I was very direct (no intervening social pleasantries).
I could sense her withdrawal ……..
What followed then from this point on, almost on a fortnightly basis, was astounding and irritating simultaneously.
As soon as this lady would get better with a particular regimen of pain relief like the first one she would come to OPD and inform me about vague and even fanciful side effects these medicines were having on her. Knowing clearly that no such side effects exist for these drugs I would either inform her so or maintain a disregardful silence regarding the issue……and at the end of each such episode I would find her admitted in the hospital next morning. Admitted at night via emergency due to exacerbation of her proclaimed side effects specially vomiting and fainting.
Then I would change her medicines to new ones and yet the same set of events would recur.
Tired of this vicious cycle my frustration began to grow and when I saw her admitted again for the third time one morning, while she was only on plain paracetamol for pain relief, it could be contained no more. The pent up frustration at this seemingly unresolvable situation had to burst out or implode within.
Obviously a patient on the hospital bed cannot be told that he/she is a malingerer, not on the face at least.

So as it is with most unresolvable issues in life, where one does not even get a chance to react the way he/she deems appropriate, it was time to dive within and ask why??

Why is this experience being given to me??
What do I have to see, learn and assimilate??
And it was effortless my pent up frustration, not finding a vent outside, had already imploded ……… I had fallen ……….. as if out of the fabric of space time net …….. into an unknown place of silence.
And it was there that it happened…………….
“Do you love your current life position absolutely???” A question seemed to arise
“Not absolutely ………..” was the reply
“Then why don’t you change either??”

“Either??” I wondered…..

“The situation or your stance (reaction/feelings) about the situation”

“I mean how can I change this situation…….blah blah(explanations upon explanations) blah blah blah…… and obviously I don’t like it this way so how can I feign to like it i.e. change my stance about it ……..”

“Isn't that a malingering??”

Suddenly I felt stabbed……the innocuous questioning had, like a dagger, penetrated somewhere very deep now and all of a sudden so.

“You complain about your current life situation, even propose a better alternative to it in your mind, resist, ridicule and humiliate the present moment for its “not enough- ness”……..but when asked to do something concrete about it you shirk away offering a barrage of excuses ………..that’s your vomiting episode……… and when asked to change your opinions about the current situation (when you are so incapable to change it in actuality) you come out in a firm denial stating , “but I don’t like it how can I feign otherwise”, that’s your fainting episode against reasoning.”

“Aren't you malingering your life away??”

I was bleeding torrentially now …………
(Suddenly at this juncture of reading you too might have felt an uncomfortable prick…..it’s a prick (and not a full blown stabbing) only due to a verbal illusion of me and you. If this question now is pointed straight at you, “Do you love your job?”; “Do you love your current life situation?”; “Are you completely at peace with it?” {Something feels stabbed now}
A defensive discomfort encapsulates you now ……….. “I mean nobody does but it has to be done”; “Bills and EMI’s have to be paid boss”; “welcome to the real world …….money is the arbitrator of our reality not words and ideas”; “what do you suggest one should do, do you have any better ideas” etc etc……
From blatant denial to assertive defensiveness the mind would position itself somewhere within the spectrum of these two extremes.
And when asked to soften your stance, forget feeling good, about whatever is (since you cannot change it anyway) the mind goes…………. “this is not what I came looking for, this cannot be the purpose of my life”; “how can I come to terms with it, it is so unfair”; “I deserve much much better” etc etc…….)

As I bled my own reality a great sense of compassion and gratitude arose within me for the lady.
At least she paid heed to her physical symptoms, got herself diagnosed and came to know that she is diseased and what exactly that disease is.
But until today I had never even paid any heed to the symptoms of anger, irritation, frustration, lack of love, lack of gratitude and wonderment, lack of compassion within me.
Until today I had never bothered to even wonder if something was wrong with me leave alone diagnosing it and attempting to cure it.
Until today I was living in a defensive premise of “this is normal …….everybody is like this”
But it was no more possible now ………..
The dagger of honest enquiry had ripped through the veils of egoic mind ………. The diseases of “self-denial”; “Follow the heard and not your instincts”; “Do things because they have to be done not for the love of doing them”: “Disbelief and Doubt” etc had all been exposed all of a sudden ………

And I was forced to ask myself

“If I am the one sabotaging myself?”

“Why is it that I believe so less about my own capacities and capabilities?”

“Why is it that I doubt the good that has already come my way but believe instantly in the most farfetched imaginations of the ominous?”

“Why do I believe whatever it is I believe about myself and life?”

“And if it does not serve me well then why do I continue to harbor it within me?”

“Isn't belief a practiced (much repeated) thought alone?”

“Why then should I harbor such self diminishing, such self destructive believes within me?” …………………

The confluence continued

The confluence continued

So there are two entities functional in this human body of ours,
1> The real primal intelligence that actually orchestrates the functioning of this extremely complex body and maintains life as we know it.
2> Something else that has little or no say in the “real life” and hence weaves an illusory web of control derived from a “reaction to the is’ness of life”.

So the real primal intelligence was a singularity prior to the big bang….no concept of time…space…..other …..even the concept of any concept……
Nothingness is what comes nearest to describing it………and from that nothingness arose all this something and the other (the entire cosmos that is).
So in principle we, the derivatives of that nothingness via the big bang, contain within us that nothingness……..and so does every other thing in this universe.

The building block of this universe, the atom, is evidence to this fact. Being 99.9999999(13 nines after the decimal) % empty, i.e. space containing nothing………and yet the will of the singularity to experience itself as multiplicity makes us and our phenomenal world seem so solid.

This is not about psychological abstractions, or astronomical figures it is about the individual that is you. But the “you” has to be put in a correct perspective and hence the need to go through these scientific facts and figures.
So how does all this sum up to something significant, something potent, something transformative for an individual???

An individual as he/she knows himself is a mere idea about himself given to him by the society i.e.
1> A name
2> A family identity
3> An educational qualification
4> A professional position
5> A social position
6> A generic idea about oneself like good/bad, virtuous/notorious, brilliant/average/dumb, humorous/serious etc …..

None of this exists without you……it has all been implanted over you ……it is not you……you are the ground, the matrix, upon which all these things happen. But painful confusion arises when this pure unlabelled I begins relating to its own self internally via these labels.
Having these labels as a social convenience is perfectly fine, to relate to others trapped in this social game via these labels might even be a necessity but relating to one’s own self internally via these labels is morose and at times painful.

And this is the confluence, the critical juncture where religions are born, practices take root and true philosophies blossom.
The juncture that reminds you to reconnect with your own nothingness which is much much vaster than your “something ness”.

Just like the atom that makes us up. Just as our constituent atoms are 99.9999999(13 nines after the decimal) % empty…..containing nothing …….so are we.

When we forget our innate nothingness and begin focusing only on the “something ness” life becomes a drag. Because we are pushing against our own innate truth, our own expansive self.

In choosing only “something ness” and leaving out our nothingness aspect we have left out 99.9999999(13 nines after the decimal) % of ourselves and that is very suffocating, very claustrophobic.
A lot arises from this juncture but before being carried away by that it would be rather worthwhile to mention the practical significance of all this.
Having clearly seen the operation of a vast intelligence within our own physiology and having accepted the nothingness as the much vaster part of the self one is now clearly confronted with a choice…………

The choice of siding his/her attention with the unknown yet innate vast intelligence in the infinite matrix of nothingness

Or

Continuing with the society implanted suffocating, very claustrophobic and yet very familiar reactionary old mindset of “something ness”

But the same suffocating, very claustrophobic and yet very familiar reactionary old mindset of “something ness” will ask “How”.
How do I shift my focus??

How do I give my attention to the unknown yet innate vast intelligence in the infinite matrix of nothingness???

And the answer to that is; that this mind that is asking these questions can’t.

This mind cannot shift the focus; this mind cannot give attention to the unknown yet innate vast intelligence in the infinite matrix of nothingness???

And that is why the religions, techniques and philosophies ……..

Focus on the breath and you are already connected to the unknown yet innate vast intelligence in the infinite matrix of nothingness that governs your life; focus on the heart beat, look incessantly at an object or hear a continuous sound (e.g. flowing of a river) etc all to the same effect. Whenever we step our attention out of the minds verbal and imagery based chatter we are connecting to our own source.

And that is why vacations are so revivifying ……..the new sceneries, locations and situations are too overwhelming for the mind to form concepts and begin its chatter so one gets connected to his source and feels reinvigorated.
But repeated visits to same vacation spot would amply clarify the fact (as mind forms ideas and concepts about the place and gradually returns with a sense of familiarity) that it’s not the place per se rather the absence of mental chatter that is so refreshing.

The confluence

The confluence

We began our generic talk titled “order, chaos and control” two posts ago on the footing of contrast …… stating ……
“The universe it seems loves contrasts and very tightly intertwines polarities be it an atom with electrons, protons and neutrons or be it galaxies, stars and the planetary systems within them, tightly strung (to perfection like guitar strings) by the opposing forces of gravity and centrifugal force.”
But then we swayed away from the generics of the universe into the specifics of personal interpretations, priorities and perceptions.
Maslow’s pyramid helped us appreciate as to why is it that different people perceive things differently.
Why is it that the answer to the questions like “who am I?”, “what is the purpose and nature of this universe?” might be the singular pressing urgencies in one person’s life. On the other hand they may be viewed plainly as futile psychological abstractions by another person.
Though the Maslow’s pyramid offered a wonderful window into the human conditioning and psyche it would be noteworthy to point out that it is not an absolute concept, just like any other concept.
And life offers stark examples to shake up the pyramids credibility. It is filled with examples of Kabir, Raidas, Jesus, Ramkrishna Paramhans, Al hillaj Mansoor, Tulsidas, Valmiki etc who had little if any means to get by in life. According to Maslow they would be at the bottom of the pyramid i.e. Biological and Physiological needs or at the Safety needs when rated at an exaggerated best and yet they have all attained a self-fulfillment, a personal growth and a peak experience humanly possible and gone further beyond.
Life it seems is repeatedly reminding that it is more specific than generici.e. even though theories and ideologies are good pointers to the path they themselves are not the path.

So what then is the path?

Paradox and contrast………………

The human mind drugged by its sense of rationality wants to see clear cut patterns and pictures and in its attempt to do so it willfully and skillfully ignores a lot only to observe and absorb that which conforms to its preconceived notions.

And that is precisely why the question ……. The question about finality of life …..The question about life’s purpose………The question about the path and the goal…….

Who is asking all this????

Is it the self ….the self that is ….the primal substratum of existence??

Is it the self, the singularity, that was prior to the big bang and then started out with the big bang becoming the chaotic soup of nebulous gases then molding itself into stars, galaxies and planets and then from the seemingly dead chemicals aggregating itself in remarkably calculated proportions with a rather unimaginable synchronicity to become alive. Single cellular, to multi cellular, to amphibians, to reptiles, birds, mammals and finally the ones who are writing and reading this on their computer screen.
Is that self asking questions?? And if so then to whom is it posing these questions??

Or is it something implanted upon it, something extraneous that asks the questions (the mind)???

And this is the point of confluence of all that has been discussed till now…….

That there is a deeper intelligence operational within us like every other living being and the so called non-living thing is amply obvious.
The heart continues to produce its own electrical impulses and converts it into an extremely precise and synchronized mechanical activity called the cardiac cycle in every beat (which takes pages upon pages of explanation in physiology text books to understand). The lungs effortlessly function to remove the accumulated carbon dioxide and refresh the body with oxygen with each breath. Stomach and the intestines breakdown the complex food stuffs we intake into the required essentials and absorb and assimilate them. The eyes are continuously sending electrical impulses to the brain which then interprets it as images. There is no real image anywhere; it’s just an interpretation or translation of electrical activity occurring on the retina by the optic lobes of the brain (beauty truly does lie in the eyes or more correctly optic lobes of the beholder). The ears are sending in compressions and rarefactions of air (the sound vibrations) as electrical signals that are then translated into meaningful words and sentences by the auditory lobe of the brain. So on and so forth with each and every organ, organ system, sense and the entire body. From the seemingly dead nails and hair to the infinitely complex brain (with its 86-100 billion neurons and around 0.15 quadrillion synapses) there seems to be an all pervasive intelligence that is functioning despite of us. That is to say that we have little if any say in our physiological functioning; and hence essentially life.

So it seems that there are two entities functional in this human body of ours,

1> The real primal intelligence that actually orchestrates the functioning of this extremely complex body and maintains life as we know it.

2> Something else that has little or no say in the “real life” and hence weaves an illusory web of control derived from a “reaction to the is’ness of life”