Atmospheres and Other Invisible Weights

I've talked to a number of people that have been feeling this particular phenomena lately, and I'm going to do my best to try to explain it.

So, the atmosphere is always weighing down on top of you.  Layers and layers of air and vapor held to the Earth by gravity, cumulatively putting 760 mm Hg of pressure on top of you or, appropriately, one atmosphere.  We're used to this pressure, this weight, so we don't tend to think about it much.  

When we travel to somewhere of a higher elevation, we feel it differently, the pressure lessened slightly and certain properties are similarly altered, such as boiling points and freezing points, and one may struggle to adjust to the difference in combating lightheadedness among other symptoms.  After literal weeks of adjustment, your body will find more efficient ways to manage your oxygen, but this takes time.  

Right now, the pressure of the pandemic, our political climate, our literal climate, etc., feels like instead of losing atmospheric pressure by changing to a higher elevation, we've managed as a world to figuratively double the pressure of the world around us, changed it from one atm of pressure to two, maybe even three.  We can still do everything that we would be doing normally, but this invisible weight now means that everything takes just that much more energy to accomplish.  Things that we used to be able to do in a normal day now feel like an impossible load, because the world weighs just that bit more.  

We're carrying a lot of things about now, and the invisible weight of those things is hard to quantify, yet they're embedded in our atmosphere at the moment.

That's grief.  Grieving the loss of normal; grieving the certainty of tomorrow; grieving the missing security; grieving the opportunities lost.  And it's heavy, coloring and weighing down those "normal" tasks.  

I mean, kind of, Doc?

Yes, that invisible weight has been settling on other people, too.  Yes, your normal tasks are harder to do when you're carrying extra invisible weight.  It's not a failure to acknowledge that or that you are differently capable at other times when there is less anxiety and dread circulating around us.  When we're unconsciously picking up on the emotional weight, it is as though the air is heavier around us.  This in turn requires more effort, and we're exhausted for it.

If you've been feeling this sensation and/or have been upset with yourself for not being productive enough in these last few months, I have two points I would want to stress to you:  firstly, your worth is not tied to your productivity; secondly and more importantly, you're not alone in feeling this way right now.  

Background, Connections, and Context

My brother and I were having a discussion the other day.  He was asking me about a resource that might help him understand biology better.  Condensing his words, a list of symptoms and treatments did not help him much understand what was happening; he wanted to understand the context of what was happening in the body to better understand a condition.  

I currently had my pathophysiology textbook in front of me, which was exactly the right resource at the time.  Pathophysiology is the study of how a disease process works within the body, what it does, what it effects, what processes it interferes with, what symptoms this ultimately drives, all in one place.  For this course, it's also paired with pharmacotherapeutics, looking at how these are treated with medicine and, again, how that medication is working to restore what processes, etc.  

I picked an example:  the pathophysiology book chapter assigned that day was a review about the gastrointestinal system (discussing normal anatomy and physiology functions) and then a chapter about a number of specific conditions that affect this system.  We talked about the stomach, how a process of ions creating a particular flow of ions are referred to as the proton pump which then triggers the secretion of hydrochloric acid in the stomach.  Too much of this could cause heartburn if it is regurgitated into the esophagus, ulceration on any exposed areas, indigestion, etc.  So if we take a proton pump inhibitor (e.g. Prilosec), this interferes with this pathway which means less HCl in the stomach, which means a higher pH/less acidity, which can then mean less symptoms.  

It all fits together.  There's a logical flow in how these pieces create the symptoms that they do, how they effect different systems.  The body is an ecosystem--everything effects everything else.  Nothing exists in a vacuum.  There's a narrative that unites these pieces, between the body as its designed to function and the disease process how it's altered that function, all still in the context of what is "normal" for that person.  

It made me think of how I think about history.  My brother greatly enjoys literature and history, finding that an understanding of one greatly enhances the other, seeing things in the context of the time and noting their different effects on one another.  Neither literature nor history exist in a vacuum:  there is something that connected those pieces together.  There is a greater weight to the context of what is happening in the story based on what history is happening around them; there is greater weight in the historical context in understanding what thoughts and ideas were prevalent in the time.  I have reflected more than once that history is better when it is told in the context of people, a round story of X led to Y which led to Z and effected these people in these ways at each step, seen through the lens of humanity and which led us to this next point--that sticks with me far better than regurgitating a series of trivia questions.

Sterilizing pathophysiology into a list of symptoms is convenient, but it is also robbing us of an understanding of the wider ramifications and decreases our overall scientific literacy.  Reducing history to trivia bullet points takes less time to digest but robs us of the rich context of how we got there and where we're going.  

The narrative matters.  The story is what sticks with us.  Connecting to what we know is what builds our knowledge base.  I just hadn't thought of it in my own context before.

This matters when trying to understand people and politics, too.  The story matters.  The context matters.  How we got here and how it leads to the next thing matters.  That gives the subject in question a richer meaning, a fuller depth that sticks with you, remembering the drive and connection if not all the minutia.  

Melvin & Me, Part 33: Melvin in the Media

In the last few weeks of my anatomy class at Heartland (before nursing school, back in April-ish), we started to cover the digestive system.  I sent a message to my instructor asking without pressure or expectation if she would like to use my experience to supplement any discussion.  She took me up on it.  Given our transition to online classes, I ended up leading an AMA (Ask Me Anything) discussion board for the class.  They were given a link to one of my blog posts to read through and then a forum to ask any question that they'd like.  A few mentioned that they had known a someone with an ostomy or helped folks through some health related experiences.  On the whole, I would say that most of the questions were in two main camps:  specifics about my particular situation (how I got to this point in the first place) and the emotional impact of it all.  

I have to consider time to time that because I'm open about having an ostomy, there is a sense of responsibility that comes with that.  I represent a community.  And I was grateful for the opportunity to speak with folks, to show a slightly different side of life.  

There are many other people here, too, but how often do you get to see something like this?

A genuine, positive representation?  Huzzah!

Ostomies are an odd kind of disability, in that I can be invisible about my ostomy maybe 75% of the time.  I don't have to talk about it.  But I need to.  I don't know how to be anything else.  I've developed techniques and scripts on how to talk about it, particularly as I'm fortunate enough to have a great therapist and people close to me that would willingly listen--not everyone has that.  And other people don't talk about theirs openly for their own reason.  What concerns me is if one of those reasons is that lack of positive representation.  

There's a difference when I talk to someone who has heard of an ostomy before to someone that has not.  For example, other nursing students have a base level of understanding and I can get right to the interesting stuff.  Seeing an advertisement that features a model with a colostomy was someone's first experience to ask "what's that?" which ultimately makes it easier to have a conversation later.  Someone starting from scratch, there's just a bit more emotional work to do, that momentary pang in the pit of my stomach:  I have to work to be seen today.  And mostly I'm happy to do that, but it does have that small emotional stumbling block.  Imagine telling someone about your home who had never heard of your country before.  There's a split-second moment where you realize something that was formative and had a depth of meaning to you didn't exist as far as the other person knew, an accidental invalidation.  You recover quickly and then try to find a sensible starting point for what that person is familiar with.  Learning starts by finding what someone already is familiar with and building off of it; finding that starting point takes time and energy to hone down.  

And that's partly why I'm vocal about mine, to at least be a starting point for persons that don't know how to talk about it.  This is media.  I'm a part of it.  I want to present it truthfully, which involves both positive and negative elements.  I want to be someone that others can point to or reach out to with "hey, I have this friend who was just diagnosed with Crohn's" or "I know someone whose son is getting an ostomy" and be that starting talking point.  When I get my nursing license, I want other nurses to know that they can snag me to help answer some of those deeper questions that patients have or for advice on how to approach a teaching situation for someone not past those initial grieving points.  And then when I can focus more on wound/ostomy specifically, I want to be a presence on the floor, even elect myself as a posterchild, if need be, for living a life successfully and openly with a stoma.  

Then the imposter syndrome kicks in.  Can I elect myself as posterchild?  Can I claim a public space like that?  Whelp.  Time will, I think, will make the difference:  the best way to establish myself is to work toward living my most authentic life.  The rest will come in time.