The Ache and Pain Game

A favorite card game when I was a kid was Knucks, in which the non-losing players took the full deck and one by one either scraped or, if they were gentler souls, tapped the loser's knuckles for the number of points she lost by.  And there could be many losing points. If they drew blood, you held your fist up in triumph.  Rocks, scissors, paper was also a particular hit – literally.  My older sister Lee and I were fond of a car game where we pummeled each other’s arm until one or the other gave in. (I think our parents encouraged it because we were quiet until either victory or defeat.)  Pain was part of the whole growing up game.  Climbing rocks, hurling snow and Dodge balls, tackling each other, spinning around until you threw up.  We baked in the sun, until we could peel off our Noxzema-wreaking skin. Very satisfying.

As young adults, pain on a more intense level became the source of major bragging rights – running a marathon, cross fit, basic training, hot yoga, labor.  The body recovered, it healed.

When we were young pain had a focus, an end, and, sometimes, a reward. You crawled up a rock and reached the top of a mountain.  You were hurled to the ground but you made the touchdown.  You twisted yourself into plow position or Wheel and achieved yogic bliss. Your body was an earthquake and then the baby came out.  Acute pain.  Ouch and over.  Joy

Nothing fabulous happens to your body as it ages.  Pain is now the unexpected random result of the body's sloppy disintegration into a chaotic mess, collapsing against the ends of its own nerves, sending signals of discomfort to the brain.   (I use the word “discomfort” the way your dentist uses it.  You know what I mean.) Muscles lose tone and are less able to contract both because of changes in their tissue and in the nervous system (even with regular exercise).  The skin loses elasticity.  Bones become brittle.  The joints break down as well.  The spine starts curling in and many of us begin to stoop.  We start walking more slowly, the arms dangling rather than swinging. 

I think many Baby Boomers didn’t think it would happen to them, propped up as we were with meditation, organic vegetables, excellent skin creams, and a delusional self-confidence.  Years ago, a then-young woman, a beautiful blonde Columbia professor said to me, “You know we’ll never get old or forgotten.  By virtue of our large numbers, advertisers will keep us young forever.” She wasn’t really right about advertisers preserving our youth (although I just Googled her and she still looks great.  Annoying).  But, she was right about the number of Olds. Except for my kids and grandkids, most of my friends, in fact most of the people I see around town, are slow, crooked walkers, stiff risers, with slumpy shoulders, saggy abdominals, and faces frozen in stunned surprise by this unexpected world, now shimmering with aches and pain.  

After I wrote the above, I stopped, trying to figure out how to end this damn entry without sounding dismal and whiney.   I got up and went to the john (TMI?), where I like to ponder life.  Without coming to any conclusion about my blog, I stood up in a very wrong way, and something within my knee clicked and shifted.  Pain flashed a sharp red stoplight.  I couldn’t walk. I called Michael who helped me hobble to bed.   Off to the ER the next morning for a diagnosis of sprained ligament and the gifts of crutches and a knee brace.  It was Christmas Eve.  I wasn’t crazy about the presents, but I liked the irony.  I now could finish my blog.

With the brace, crutches, naproxen, and the occasional fabulous tub bath, I hardly had any pain, just awkwardness and a bout of self-pity, which lasted long enough for me to yell at Michael for not serving me as much as I felt I deserved.  And then the realization followed that this won’t be the last event of this type, and I need to figure out how to do this without becoming crazy, mean, and bitter.  So it’s fitting that I stop writing, and start creeping about the kitchen on Christmas Day, propping myself up, while trying to cook soup for a couple of old (in the best sense of the word) friends, who are coming up bearing smoked salmon.  And, I guess that’s the lesson.  How can we cook as long as possible for our old friends, wobbling about, while working through pain’s last game and making it a celebration.  Ouch and onward.  

Advice to the Newly Miserable

One advantage of being an Old is having lived through the elections and dreary administrations of Nixon, Reagan, and Bush and finding the country still staggering along afterward.  And whether President Drumpf will beat these crooks, actors, and dopey beer drinkers in perfidy, ignorance, and lousy judgment is still uncertain.  He's a salesman.  He wants to be loved and he wins customers, even without a product, by telling them what they want to hear. In Greenport, where I now live, our new President has enough happy customers to beat Clinton by 25%.  Whether the magic beans will satisfy them is unknown, but what's clear is that those of us who did not buy his line need to come up with a competitive product.  So, some obvious thoughts.   

1. To the National Democratic Party: you are out of touch with many Americans, particularly those in the boonies.  Example: Our mostly rural congressional district had no incumbent this year and was up for grabs.  We had a local fourth generation farmer, an Ivy League graduate, who decided to run on the Democratic line.  He was progressive and deeply understood the local issues and what was important here. Then in swooped Zephyr Teachout, who had valiantly opposed Governor Cuomo and lost to him in the last gubernatorial primary.  Unfortunately, this year she left Brooklyn, bought a house in upstate New York and went up against our farmer.  She is energetic, pitched the standard Dem line, and had achieved some measure of fame, so the New York Times endorsed her and the DNC gave her a bunch of money. I'm not sure if anyone from these organizations even talked to the farmer.  So she beat him in the primary, but after being dubbed a carpetbagger by the Republicans, not surprisingly lost in the general election to a local hack.  She's a good potential Democratic leader but should run in Brooklyn, and the farmer should try again in two years with some party muscle behind him.

2.  To the Millennials who wanted to vote for Bernie in the primary but couldn't and so decided you were being scammed: you weren't. You were registered as Independents or worse, not at all, and shut out of the primary because this is a party election – not general. Take a civics class and educate yourself on why primaries are closed, then join the Dems.  The Democratic Party still has good bones that can be tilted left with enough internal muscle to incorporate Bernie's best workable ideas. 

3. And, to continue, don't just register as a Democrat, start working for the party. One reason the Democrats lose is that, outside urban areas, they have a very small very old local presence.  If there's no local Democratic base, there are no local candidates who can win their way up from town and state elected positions into the national scene. In our town of 4700, only about a half dozen Democrats actually do the boring, unromantic, crumby political labor. It isn't fun. And your fellow party members are typically community rejects and unlikely to be Mensa candidates, but many have fought the good fight for years against a Republican elephant that has lived here forever. They need your help.

4.  In fact, if you can work remotely move to a Republican town or district. Change the demographics and get to know your neighbors.  They nearly all have guns but very few have killed anyone. There's a source of desperation in these communities that's important to understand and to resolve: lack of meaningful work at meaningful wages.  It encompasses race, gender, and religion.   So move out and work for the party. It's beautiful out here and we need your participation (although don't run as a candidate. You'll lose. Leave that to your grandchildren). 

From DNA to the Stars

My sister Ginny recently learned about telomeres, tiny fuses that cap the end of our chromosomes, protecting them from damage by their neighboring peers.   Every time a cell replicates the fuse shortens until it disappears and the cells die; eventually they all die, and so do we. "I felt really comforted by this," she said. "That we just wear down, nothing we can do about it. We just end." I told Ginny that I had received a similar comfort after getting my DNA results. 

At the urging of my daughter, I had sent my first spit sample to ancestry.com, which has a clever system for family trees that not only allows you to locate and add relatives, but provides links to historical records, if available, which may even have stories about your forebears.

For example, I am directly descended from Miles Standish, referred to as Captain Shrimp by his peers. No longer a Pilgrim icon, famous during my childhood as Pricilla Alden's rejected suitor, he is disappearing into the ashes of history, a nasty, short soldier who stabbed and killed a native chief during peace negotiations. I also discovered John Darby among my forebears, who, when he was about forty, impulsively joined up with a pirate crew one afternoon, leaving his wife and five children.  Unfortunately, he was killed two weeks later by the British militia and was subsequently referred to as the Neophyte Pirate. And, then there was my extended great grandfather Andrew Elliott, a Salem judge who hanged witches and later apologized.

Amused but not necessarily comforted by the human examples of my genetic heritage, I decided to learn more about its medical implications, especially my risk for Alzheimer's, which ravaged my father's brain. So, even though no measures exist to prevent this from happening to me, I sent another saliva vial to 23&me, a site that focuses on physical traits, and then paid five dollars to another site, promethease.com, to pick up my DNA results for additional findings.  Promethease provides more information on disease risk than 23&me by identifying studies that are looking at specific genes.

Using both sites, I learned that I wasn't a carrier of a dozen or so very rare diseases and that I was likely to have blue eyes and wet earwax and I wasn't a photic sneezer.  I'm 4% Neanderthal, which is a higher percentage than that of 99% of the population, and I also have a warrior gene and one that suggests low empathy levels, all of which might produce whimsical impulses for piracy, hanging witches, sticking knives into people, and getting married three times.  

I was relieved to find no APOE4 gene, currently the one most strongly associated with Alzheimer's risk, but it's still early days for research into genetic causes of complicated diseases like this one. Collaboration among other genetic and biologic factors could contribute to brain eating, so I'm still not out of the woods.

It's important to note that drug companies scrambling to transform bad genes with zillion-dollar custom-made pills are funding much of this research. Little money is looking at beneficial genes that might already protect us, because they are unlikely to become cash cows. And even if scads of non-pharma research money were available, studying the microscopic DNA cosmos and figuring out how it hurts or helps us is literally an astronomical task that will take years to sort out.

Sixteen years ago scientists put together the first draft of one entire human genome. Because everyone's genome is roughly like everyone else's, the current way of analyzing an individual's genetic profile is to reference it against that first draft. The results that come back from ancestry and 23&me are mostly about SNPs (single nucleotide polymorphisms), which are single variations on a DNA base.  Their locations on specific genes help supply information on individual physical traits as well as susceptibilities to disease and environmental factors. 

It should be noted, however, that just 20,000 genes, more or less, provide the codes for manufacturing the basic stuff of our life force. They comprise only about 1% of the whole genome and are scattered like planets among 3.2 billion DNA base pairs, most of which form large non-coding patches. A few of these structures have been found to perform key functions, such as switches that turn genes on and off, but, so far, most appear to just float around uselessly, micro-asteroids within the genomic universe.Too add to the complexity, we also have about 14,000 pseudo-genes, which don't code but are inherited from one generation to the other and hang out like freeloading cousins. 

And there are problems in gene duplication.  Think of a malfunctioning book printing press. Sometimes it makes multiple copies of a page.  Sometimes it skips a few, which at best means losing a couple pages (i.e. couple of sentences) in a Henry James novel or, worst case, missing key parts of a Harry Bosch plot.

Bottom line, by the time scientists have doped out all the genetic factors and processes that lead to my Alzheimer's risk, I will have long since personally experienced the answer relevant to my own biologic fate and passed on.

So, to return to the conversation with my sister, where is comfort in all this?  After attempting to puzzle out and failing to understand the science of genetics on any non-superficial level, I was left lying on some mental earth staring at those billion or so DNA bases carrying their light-years of information within their coiling and uncoiling packages, the double helix, dancing to the unceasing music of Irreconcilable Dualities -- digital and analog, particle and wave, male and female, order and chaos, life and death. I experienced the same ecstatic insignificance as I would looking into the dark backdrop of the night. Just as the external stars don't belong to me, neither does my DNA; it is merely renting me as it twirls through my time-space until the last telomere drops off. And if this doesn't comfort you, nothing will.

A few weeks ago, I went to a family reunion, the 90^th birthday of my last aunt, one of six sisters who all had various numbers of children, so that I ended up with 24 cousins on my mother's side. So here we were, genetic comrades, most over sixty, eating cake, singing the same schlocky camp songs of our childhood, harboring similar left-wing politics, and locked into matching bone sets, silently sharing our internal histories of Captain Shrimp, hanging judges, and low-browed Neanderthals witnessing their own extinction. It was probably one of the last times we will all be together living and lively, so there was an element of sadness.  But at the end of the evening, our wonderful aunt, on the verge of finality and cloaked in mild dementia for most of the night, looked up at this crowd of children, nieces, and nephews all winding and spiraling about her, and she laughed.

[Note: one terrific way to crash your way through this DNA thicket of information is a series called Game of Genomes, in which Carl Zimmer, the author, decided to get his entire genome analyzed by a number of experts and to write very clearly about it.  (https://www.statnews.com/feature/game-of-genomes/season-one/)]