Retirement Talk

WHAT to do with the rest of your life?

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Episode 16: Health and the Importance of a Second Opinion 

My mailman, grocery checker, and cabinet-maker all have scars on their wrists.  Repetitive motion is responsible. Carpal-tunnel syndrome rages across the country like a junior high fad. After playing the classical guitar for two or three hours each day for several years, my hands felt the pain and agony of something gone wrong. Though threatened with the knife, I escaped the procedure. Personal experience and a strong resistance to surgery revealed a surprising analysis for me.

Health decisions seem to mount as we move towards retirement. We are faced with choosing between alternative treatments. What to do? Where do we turn for advice? Most of the time, we can readily agree with our doctor.  Other times, it just doesn’t feel right. We seek a second opinion.

For my hands, my family doctor prescribed drugs to reduce the inflammation. I’ve always practiced a minimalist approach to taking any sort of drug and so I didn’t take what was prescribed. Later a hand-specialist took X-rays and prescribed a different drug. Once again, I refused. Then a neurologist suggested yet another drug and pronounced the presence of carpal-tunnel syndrome. He recommended surgery.

Reluctant to accept the drugs or the surgery, I searched for yet another answer. Inquiries led me to a source that was in Seattle . I was referred to a hand surgery clinic where doctors examine hundreds of hands each month.

I called the clinic and inquired as to the necessity of surgery in all cases. I was assured that not all problems required surgery.  Promised that I would just receive an examination, I drove the ninety miles south with high hopes. A disturbing scene greeted me: in the office were several patients waiting for their doctor. They all had bandages on their hands. Everyone had bled. I wanted to flee, but the long drive and my wife demanded that I see and hear the expert.

Dr. John Sack appeared to be in his early fifties. He was tall, with an athletic build and a gentle presence. He was in no rush. Looking at my chart, he asked me about my occupation or retirement: how I spent my time, hobbies, kids, wife, diet, physical activity, and medical history. He even inquired into my attitude towards life. As a former teacher of philosophy, I particularly warmed to that question. My existential bent was briefly  illuminated in the small room. I told him of the intensity with which I approached each day and yet accepted the absurdity of life. He told me a little about himself – his career choice and his rowing on Lake Washington each morning. He gave me time and set me at ease.

He then put me through a series of hand gymnastics. “Push here. Pull there,” he commanded. “Do they hurt when you sleep? When you walk?” He looked at my hands.  “Is there any pain at the moment?” There was no pain.

He handed me a small piece of paper and a pen and asked me to write.  “Write anything. It doesn’t matter what it is.”

I wrote only three words and the Doctor and the nurse broke into loud laughter. They looked at each other, shook their head from side to side, and then laughed some more. 

They excused themselves for laughing and then asked me to continue writing a little more.  Reluctantly, I put pen to paper for just a few words. Sweat broke out on my forehead. Embarrassment swept over me. I sensed the analysis.

The Doctor shook his head and said that I had written enough.  He explained that the laughter was because he had never seen quite such a severe example of my problem. “It is text book,” he said. Then he went on, “ Del , you’re just not that important. You need to let up.  You’re going to press that pen right through the table. I’m surprised that you can play the guitar at all.”

The doctor gave me the medical term for my problem and then said that it is commonly called “white knuckle disease”. When I wrote on the paper, my knuckles had turned white instantly. My effort far exceeded that necessary for the task. I grasped the pen too hard. I pressed on the paper too hard. The wise physician looked at my hands and saw clearly into my mind. The intensity with which I lived life had to be harnessed, reduced, or controlled. My existential attitude had created an intensity that was overwhelming my body.

He advised me to go home and play my guitar, and even more importantly he advised me to let up - when playing music and when not playing music. On parting he said, “I should never see you again. You just need to relax”.

Within two weeks my diastolic blood pressure had dropped 15 points. Many times during the day I would give myself relaxation tests. I would focus on the hands and see if I could relax them more than they were. I always found them tense. They would be knotted while walking down the street; tight while I was washing the dishes, reading the newspaper, or driving the car.  They would even be tight when I would wake in the middle of the night and give them a quick check. I began noticing the tenseness in my tongue, checks, back and everyplace else. I had never noticed this all-encompassing tenseness. It had become a way of life.

Habits developed over a lifetime change slowly. It has been almost 10 years since my visit to Doctor Sack.  Now my hands are relaxed as well as much of the rest of me.  I felt stupid about causing so much grief to myself, but I felt good about refusing the drugs and the surgery. Fad treatment for a problem that is difficult to diagnose may not address the true problem.

Spinoza believed that the mind and body were one. In my case, pain attributed to repetitive motion, was really a mind problem. My heart, as well as my hands, is benefiting from a true physician who does understand carpal-tunnel syndrome and the art of healing.

This is Retirement Talk. 

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