The Hour of the Wolf and the Sabre-Toothed Cat.
WE’VE ALL EXPERIENCED IT. That diaphragm detaching pang of the stomach turning over despite ourselves. Envy. “O! Beware, my lord, of jealousy; it is the green-ey’d monster which doth mock the meat it feeds on.” So wrote Shakespeare of envy, drawing from the idiom of the green-eyed family cat as it toys with a mouse, seemingly desiring its prey and hating it at the same time. I reported to chemo on Friday for my routine port-flush. Every six weeks now I go in, answer a battery of questions: "How is your fatigue?" "Is the neuropathy improving?" "Any digestive upset?" Then I take a deep breath as they insert a IV needle into my chest, check the port's functionality, flush it with saline, and I'm out the door. It's a brief 60 minutes out of my day and presently the clearest reminder that my situation remains fundamentally a medical one. I've been living more with cancer increasingly in psychological terms since last meeting with my surgeon; the day-to-day reality moving from Rolling Thunder to Détente. There's a thought: Living with Cancer. When I first started treatment, I was already at stage IV. Had the diagnosis and treatment come any later it would have killed me. Living seemed little more than an abstraction, a technicality. It still might kill me. I distract myself with learning how to live, and deriving something to live for.
We do tend to regard cancer in strictly medical terms, consigning it to the realm of the material which of course it is--runaway cellular replication, consuming the body from within. Still, there are other aspects of cancer's ravenous consumption that go under-acknowledged in the cultural gestalt: The mental and spiritual. It was a question of origins regarding my cancer that brought me around to considering this arcane dimension. Was it just a genetic bomb that went off in my cells? It came to light, only recently, that a maternal grand uncle died from the exact same type of cancer I have, colorectal adenocarcinoma, at the age of 57 sometime in the mid 1950s. It goes without saying that he didn't have access to the cyberpunk medical technology that I have in 2019, and yet given the aggressive nature of the disease, my own outcome may or may not be much better.
We use stress as a scapegoat, blaming everything that goes wrong in our lives on it. Your boss is a jerk. The morning commute is a hassle and [wherever you happen to live] drivers are the worst sort. But can your boss or your commute give you cancer? Imagine, if you will, that you're walking through The Great Plains 10,000 years ago, and you encounter a large predator--I'll employ the old chestnut of clichés: The Sabre-toothed Cat. You feel that telltale wave of cold surge through your chest. Your heart seems to skip a beat, then accelerate. Your gut clenches. You freeze. Your Hypothalamus has just cued your Adrenal gland to flood your body with a steroid hormone called cortisol. This is your body's alarm system alerting your body to imminent danger (physical or psychological). The flood of cortisol is temporarily shutting down unnecessary systems to facilitate the appropriate response to a perceived threat: "fight or flight." Each requires a massive surge of energy to be available to the muscles, and a dulling of the awareness of pain. It's an adaptation to conditions of Darwinian Selection, under which our distant ancestors evolved. Food scarcity, lack of shelter in a harsher climate, proximal relationship to other predators, resource rivalry with competing Human groups etc.
The human body certainly hasn't changed all that much in 10,000 years. One could figuratively say we're Neanderthals with Nukes when you get right down to it--adapted to a primordial order that no longer exists. For most of us, living in the developed world, we're enjoying conditions completely alien to those our ancestors, through the processes of Natural Selection, adapted to. Food isn't scarce. The climate is more hospitable. Competing predator species have been pushed to the margins of their ancestral habitats, or their populations significantly reduced. Yet in the face of those facts we continue to report high levels of stress. The model of Allostatic Load, formulated by McEwen and Stellar in 1993, is a method to formally conceptualize "wear and tear" on the body due to chronic stress. Allostasis is the body's self-regulating mechanism that minimizes physiological effects on the body from outside stimuli. A chronically activated stress response is referred to as Allostatic Load. An accumulation of Allostatic load can result in permanent alterations of the brain architecture.
What jumped out at me in reading papers on Allostatic Load (I'm a real hoot at parties) was this: Humans are uncertainty avoidance machines. To break this down we have to start with the concept of the Baysian Brain, a idea from the 1740s wherein Thomas Bayes asserted that the human brain uses effects--sense data-- to predict causes. It was mathematician and cryptographer Claude Shannon who, in 1948, synthesized this idea into the axiom "information is the reduction of uncertainty." Skimming the event horizon of Immanuel Kant's “A Critique of Pure Reason,” where he argued for the distinction between a priori and analytic judgments, we eventually arrived at a theoretical construct: An organism can make predictions about input, relying on an internal model of the natural world, but the sensations it encounters may violate those predictions. As predictions are disproved, uncertainty is eliminated and certainty can be gained. With certainty comes a reduction of surprise, thus an organism can plan ahead and insulate themselves from certain stressors.
As a casual thought-experiment I assumed that the levels of chronic stress human beings experience under Darwinian Selection and now are roughly similar; moderately elevated levels of stress punctuated by sudden but brief instances of high "fight or flight." It has been suggested, in the annals of pop-science, that the key difference between the modern experience of stress and the ancestral one is that modern stress is chronic where ancestral stress would be more frenetic--experienced in short, unpredictable bursts, followed by a cooldown period. I'm no scientist, just a nerd who reads a ton, and the more I thought about this categorization of stress types, the less I thought it held water. The case could be made that arguing modern chronic stress as something alien to our ancestral past, unique to modernity, and is thus a crisis is employed as a dubious critique of Western capitalism. How can there be any doubt that our pre-neolithic ancestors would have faced chronic stress just as we do? Resource scarcity and constant environmental pressure would have kept them continuously engaged in the labour of survival. That labour itself would have been manual, which would imply at least a moderately elevated stress level, through physical exertion, above what we would expect from a body at rest. There had to be more to it. when I compared my own lifestyle to that of my peers, mere chronic stress wasn't enough to explain the Allostatic Load I was experiencing. Everyone was overworked, spread thinly, juggling commitments, responsibilities, and obligations punctuated by the odd crises or emergency--the equivalent of the Sabre-toothed Cat in our immediate environment. I modified my thought experiment. Assuming a roughly similar Allostatic Load, could I clearly identify one thing about my lifestyle that differed from that of my five closest peers? Based on conversations and observations of their life outcomes, It appeared that while their Allostatic Load were indeed similar, I experienced a higher degree of chronic uncertainty than my peers reported.
Apart from just over one year when I held a position at an Agency I have been a freelancer, running my own business for 12 years. I'm sure some of you out there can relate to the roller coaster ride of self-employment; no consistency. Feast or famine. Periods of meteoric momentum and elation, followed by the doldrums of stagnation. Professional bipolarity. You are constantly throwing shots in the dark at the market trying to see what sticks. The pressure can be tremendous, every success and every failure is on your shoulders. Plus, it isn't always clear what works and what doesn't. The effects of your choices, and sense data cannot reliably violate your predictions. You are in a constant state of doubt. You exist in the glasshouse, the oubliette of uncertainty. I intend no hyperbole in my use of prison imagery. That's what freelancing in a creative field can feel like. You see clearly what success is possible, but you can see no clear path of getting there. Further, I was with a partner whose day-to-day experience was very much the opposite. She was a para-educator working towards a teaching degree, existing in a social and professional order with overt milestones for progress and a clearly delineated path to success. Following program (A) would lead to outcome (B). She could make predictions and enjoy a degree of certainty that I couldn't and we both found that frustrating. My attempts to gain access to a realm of greater certainty were less than fruitful. I would throw hundreds of resumes at local agencies, apply for numerous positions that matched my skill-set, push beyond my natural introversion by networking, by meeting with people. 98% of the time I would receive dead-air; my follow ups dipping into a black hole of irrelevance. To make matters worse, I could detect no link between cause and effect. I would make dozens of permutations of my resume, rework my website and showreel, write unique and personal cover letters to each person I reach out to, meeting only static. Dead air. At times it felt like tossing a large boulder into a pond but instead of a predictable and satisfying splash, the boulder just vaporizes with an infinitesimal cartoon POOF at it hits the surface of the water.
I had identified a high uncertainty load, but it wasn't just uncertainty derived from my inability to make reliable predictions about my environment, it was also an existential uncertainty about my place in the tribe and my ability to self actualize. Abraham Maslow's 1943 paper "A Theory of Human Motivation" proposed a hierarchy of needs that drive human motivations. The base physiological needs (food, shelter, safety and security) required satisfaction before the more complex and abstract psychological or emotional needs could be considered.
Maslow's Hierarchy has been expanded and improved on over the years, but the basic principles are sufficient for this writing. Human beings are social creatures, but we are also hierarchical. I had certainly achieved enough status to put myself halfway up the illustrated hierarchy. My basic needs were met through my own efforts, but I did not feel that I had sufficiently met my needs for "love and belonging," "esteem" or "self-actualization." I have a few close friendships, none of which were threatened in such a way as to knock me to a lower rung of Maslow's hierarchy. Love and belonging is, of course conditional, and my demonstrated inability to attain sufficient social status to satisfy the hypergamous selection mechanisms of my partner's subconscious would place "love" in jeopardy and it was indeed ultimately lost. The difficulties I faced in my attempts to gain certainty, by moving to a higher and more stable position in the social hierarchy, lead me to chronic self-doubt and feelings of exclusion and worthlessness. My need for esteem was therefore unmet. With deficiencies in subordinate needs, self-actualization (and by extension metamotivation where the self-actualized person pushes beyond the basic needs towards full potential), according to Maslow's model, cannot be achieved.
I began to consider if there was a degree to which love, belonging and esteem could be re-classified as base needs given that, in a state of Darwinian selection, cooperation is essential to survival. At its most basic, without others in the tribe to guard you while you sleep, you are vulnerable to threats in the environment (predators, rival tribes). Without a manifest feeling of esteem, one could feel uncertainty about his security. Since the human nervous system is still wired for Darwinian selection, my feelings of exclusion and worthlessness in face of a sustained period of professional rejection, would have been experienced as an existential threat by my nervous system - which wouldn't know the difference between underemployment and a Sabre-toothed Cat. Allostatic Load would mount, cortisol levels would remain high for extended periods of time and high cortisol levels suppress the immune system. Impaired immune function reduces the secretion of interleukins and interferons, a chemical picket-line integral to keeping cancer cells from developing. With a slightly heightened risk of developing cancer at the genetic level on one hand, and a high Allostatic Load due to perceived existential threat in the other, it wouldn't take much to see how I ended up on this path.
Perhaps Nietzsche said it best when he wrote:
“Here lies the antagonism between the individual regions of science and philosophy. The latter wants, as art does, to bestow on life and action the greatest possible profundity and significance; in the former one seeks knowledge and nothing further -- and does in fact acquire it.”
I'm in no way making a scientific claim, nor am I asserting any of what has been elucidated here as causal, but I do see correlations. In six weeks I'll begin genetic counseling and hopefully will be in a position to discuss such thought experiments with people who actually know what they're doing. It'll be interesting to see if I'm barking up the right tree. In the meantime, I'm doing all I can to minimize Allostatic Load. Between the usual quality diet and exercise, I'm turning my efforts to finding ways of minimizing perceived existential threats. My first method of doing so is to severely restrict my use of social media. This is critical during a time when my condition has placed me on the sidelines, with a limited ability to maintain, let alone, improve my status in the social hierarchy. We've all felt that pang of envy when we view Instagram and we see others doing well, by all appearances, perhaps even enjoying something we aren't or can't. We know that behind the veneer are the struggles and uncertainties we aren’t privy to, but that knowing resides in the rational conscious. Our nervous system has already reacted. The damage has been done. That pang of envy you feel? It's not the desire to have what others appear to have. Rather, it's a signifier that a drop to a lower rung in the social hierarchy is imminent and therefore our ability to master and survive nature may be impaired. We've either fallen to a lower position of status, or fear we are about to. I wonder if, for those of us battling cancer, and facing a similar long-term illness, this status anxiety is profoundly heightened.
