The Mind Is the Life

Lately I’ve been reading up on vasovagal syncope, largely in response to either a) a bad take by a cardiologist or b) a bad bit of listening by a patient. In essence, a feller came away from a cardiology appointment at which his doc told him VVS is perfectly normal and nothing to worry about. As a guy who just dropped his very kind but not very helpful primary care physician, I suspect I know how that miscommunication went down.

At bottom, VVS is pretty common, and it’s also self-correcting; the faint-and-fall outcome is the body’s way of getting more blood to the noggin. My guess is that the feller heard his doc but misunderstood.

The tricksy bit of business with VVS, which I was diagnosed with earlier this year, is that it is the body behaves more or less as it should: the vagus nerve responds to some stressful stimulus (via the sympathetic nervous system) by overreacting (via the parasympathetic nervous system) and flooding the body with the chemicals it needs to calm down. It overshoots the mark, alas, which yields a hard drop in blood pressure and, in many cases, a drop to the floor. The test they perform to confirm the diagnosis is called the tilt-table test, which is more or less what it sounds like. They let you relax for a spell, then strap you to a table and tilt the body slightly past vertical, so it would fall over were it not for the straps. In my case it yielded a brief fainting spell when my blood pressure dropped down to 2 mm Hg.

The tough part for me is that I tend to associate stressful discomfort with growth, which obliges me to be as granular as I can be. The spells of VVS I recall very well have a predictable course: I get tunnel vision, which often yields to a feeling of lightheadedness; then I flush very warm for a bit, and then I’ll drop if I haven’t taken any measures to avoid doing so. Most of the disasters folks report seem to happen while they are still figuring out what’s going on. I took a couple falls in the early going, which yielded a dinged-up elbow and a bit of analytic paranoia.

I’m now in an era of active meta-analysis, which is not the fun-fest they make it out to be in the brochures. It means I’m now spending a lot of time reassessing the stuff that gets me worked up. I might have mentioned before that I’m not a big fan of grocery shopping, for instance, though I do most of the shopping here at the Abbey. Back before Target decided to consign itself to the scrap heap, I would shop at the local store right when it opened around 8:00 on Tuesday. That meant that I was in and out in 30 minutes or so, since the aisles were empty. These days I shop at our local Meijer at around eleven o’clock on Tuesdays, and it tends to hit a bunch of little stress triggers that add up. The building is a little warmish, and the aisles are full of folks with a nominal understanding of spatial relations. I can almost feel the stress building up if I don’t talk myself down and pay attention to the fact that my eyes are scanning as they should. I usually calm down when I realize that no tunnel vision is happening, though I might feel too warm and a little honked off.

Granularity seems to be the key, especially since VVS is neurocardiogenic. The tough part for me, at the level of meta-analysis, is that I have a tendency to expose myself to discomfort on purpose in order to move my own existential goalposts. As the Meijer example might imply, I find certain kind of social engagement stressful. I don’t like having to engage with anyone at the grocery store to begin with, so the fact that I often need to say “Excuse me” so I can get by some jackass who has blocked an aisle with his cart is a significant annoyance to me. I’m learning to monitor/process it better, but it usually means wading into unpleasant environments with plenty of triggering stressors when I’m already a little worn down. I rather suspect my cortisol levels are through the roof most of the time, so on a day like today, when my visit to the gym was curiously complicated by folks devoid of situational awareness (the ROTC guy who decided to do planks and completely obstruct one of the major thoroughfares, for instance, or the kid in the Dragonball Z shirt who decided to station himself right in front of the water fountain as he fiddled with his phone), I have to remember that it’s a me issue but also a real thing with real effects.

It helps that I’m a teacher who came to terms long ago with the understanding that learning is, alas, a major source of discomfort. Admitting that I suck at something, or that I’m an ignorant baboon, is never easy. But ambling headfirst into the stress mines is something I can still manage, and I learn a little more about my system tolerances every time out.

The Discipline Dilemma

In prospect, this sounds like it might be a terribly sexy post. I regret to inform you, alas, that this will actually involve a bit of my conventional noodling and navel-gazing, though I hope the result is of some value.

As I’ve surely established by now, I have a deep and abiding fetish for metacognition. I love me some thinking about thinking. Today, at least, I’m thinking about generative, positive, and even optimistic thinking, which is not my usual wheelhouse.

Long ago I remarked on the comfort I take in focusing my thought and behavior on what actually falls to me, personally, as a critter. I think about that ethos quite a bit at the end of a semester, since I will spend several days reaching out to and awaiting response from students who need a little nudge to remember something they’ve forgotten. Most of the time I dread The Day After, since that’s often the day when those students finally open up their email or else realize (with their final grades in hand) that they could have changed outcomes to some extent. It’s a sort of worry I’m prone to, though it does me no good. I try not to think of myself as a worrier, but by golly, I’m one of those worriers.

Worry, as it turns out, is a pretty simple imaginative expedition. Because I have a fair amount of experience with stuff going badly in the past, it’s not too tough to imagine other things might go the same way. It’s thought on easy mode, though it’s not easy on the old noggin. It doesn’t require much self-discipline to lapse into a default mode when doing otherwise requires energy and what can be a significant expenditure of cognitive energy.

I am pleased to report, however, that it’s possible. It just requires a lot of revision, both the American and British senses of the word.

For example, early this year I fainted and took a spill. As with most such occurrences, I was bewildered and really didn’t know what had happened. I wound up with a smashed toe and a respectable bonk on the head, and a subsequent visit to my primary-care doctor concluded that a smashening and a bonkening were about the extent of it. He sent me in for some blood work as well, though it turned up nothing actionable. The good/bad follow-up news is that I had a full-blown episode of syncope (which is the fancy name I prefer) a month later, sitting down and playing a Rainy City game on Friday night with my friends.

It’s super-easy to focus on the mediocrity of my doctor, the crunchiness of my toe, the cavalcade of tests that annoyed me for all of March and April, etc. It’s harder but wiser to accentuate the positive instead, which requires a more significant reconfiguration of my habits of mind. For example, the two episodes yielded relatively injury, which tends to be the most significant side effect of the whole business. Better still, the process of diagnosis yielded a benign outcome and an excellent new cardiologist. I went into my follow-up meeting with him to analyze my test results, though they seemed to me conclusive, and he sent me back into the wild with solid recommendations and answers to all my questions about managing the whole deal.

The trick is to recall that mode of conceiving of things and to persist in it, to keep redirecting my noggin whenever is starts heading down Dejection Street. With the new cardiologist’s advice in my pocket I returned to the gym this week, for example, and I was disheartened for a bit by the retirement of the old stair climber I’ve used most every summer. I freely concede it was old and due to be sent to the auction block, but it was still a bit of a letdown. But I can still go to the gym without restriction–save to be mindful of all the run-up symptoms that prefigure a spill. I normally focus on losing weight over the summer, but I can always work on building muscle instead. And I’ve got a pretty open summer in which to work it all out, with exercise in the morning and writing in the afternoons. It’s an enviable schedule, though my mind is natively wired to think about how much printing and shipping hard copies of Chancers is going to cost, about how I’m going to fill in the last few blanks I’ve got in the artwork column, etc. When my brain sets out in those directions, it generally takes an act of will to turn down a side corridor or to turn entirely around.

I think it’s something of a byproduct of our doomscrolling debauchery, since its easy to get caught up in the latest revolution in sociopolitical strangeness and dwell on it all the livelong day. But going against the grain of that tendency can feel a lot like optimism. A good example occurred last evening, when a scene in a show I was watching put me in mind of some new sociopolitical thing I’d encountered earlier in the day. Rather than revisiting it and fretting about it, however, I instead asked myself why I ought to bother and then spent fifteen minutes or so challenging my own penchant for such nonsense. I’m plenty informed, so the need to gather more info about some troublesome subject is small, and in a rare turn I managed to talk myself out of a deep dive into arbitrary woe. I won’t say I’ve logged enough practice to do it on a regular basis, but I can say I’m getting into the habit of practicing. And that, when you’re as well-versed in the ways of woe as I generally am, is a heckuva thing to carry into the summer months.

A 5/17 addendum:

A decent case in point: a storm rolled through late on the 15th, and we lost electricity in our neighborhood thanks to a power line downed by a fallen tree. When all is said and done we probably tossed out about $250 in groceries this morning. But they’ll be easy enough to replace, none of the trees I fret about fell, the outage aftermath chanced to fall on a day that was mild, weatherwise, and most of the perplexities we faced took about an hour to remedy. I am in point of fact terribly stressed by disruption, but it’s easy enough to round the corner from such episodes when you look at them rightly.