mahiwaga

It is easy to fall into the trap of believing that causation means intentionality. Lots of things happen where you can trace the chain of events, see exactly how one thing leads to another, and all of these things could be devoid of intention. While each decision may be made by a rational agent, the sum is not greater than its parts.

This is why design by committee tends to fail. A series of rational decisions made by multiple intelligent agents tends to result in utter chaos—in the formal, mathematical sense of the word. None of us can predict the outcome. If we could, we’d be able to beat the stock market, and probably end war forever, too.

The inverse is plausible as well. A series of non-rational, purely physical/chemical decisions (likely mediated by quantum de-coherence), when summed up over geologic time, can give the illusion of intelligent design.

So searching for reason can sometimes be futile. As it is, I can barely understand the convoluted inner workings of my damaged brain.

For better or worse, I am who I am.

The best I can do is to try to get better every hour, every day, and not look too far ahead.

Even psychological wounds need tending to. Like physical wounds, you need to clean out the necrotic tissue and the pus, and keep it clean and dry. After that, there isn’t really much you can do but let the body do its thing. In time, the wound will fill up with fibrin, the fibroblasts will start making scar tissue, and little by little, the wound will close.

Some wounds are so bad that they’ll never heal, or sometimes your body just doesn’t work well enough to heal properly, and sometimes you may just have to cut your losses, in a literal sense. Amputation is sometimes the best you can do.

I think of that Arthurian archetype of the [Fisher King][1], with the wound that will not heal.

I think of some of my patients in the spinal cord unit, with extensive wounds that seem unlikely to ever heal, and who have already as amputated as possible.

I think of all the vets with PTSD, from trauma suffered in the jungles of Southeast Asia, and more and more commonly, suffered in the unforgiving desert of Iraq.

I wonder if there is a part of my soul that I just need to amputate, and learn how to deal with the loss.

Each day, I can only hope to keep the wound clean, and let the body/the mind do its thing.

lightning strikes
end points and infinities
waves and foam
the clouds coruscating against the setting sunlight
a gull takes to wing
fluttering, fading beyond the horizon

this singularity
complete totality
ciudad de los todos santos
everything in everything
all from nothing

what am I, who am I
will I be?
am I?
dangerous crossroads
perilous pathways
sacrifice
regret

flotsam and jetsam of the waves
the sealion lies still in a quiet pool
unmoving

the cloud obscures
reveals
transforms

all the rivers run to the unforgiving sea
to that infinite line of blue and blue
where the sky and the sea
touch
until the end of the world

A man was seen by his doctor.

“You need to stop masturbating,” the doctor said.

The man asked, “Why?”

The doctor replied, “Because I’m trying to examine you!”

This was a joke I found on my iGoogle front page, but the scary thing is that this an all-too-common occurrence on the wards. You don’t even have to be a female M.D. or R.N. to be treated to full-frontal nudity every morning.