Concept 7: At least there is still suffering

The Ouroboros, the snake that eats itself, a creature struggling to survive by eating itself and simultaneously creating its own suffering. Photo by JM Watson

I have been fascinated for some time by the ability of the human spirit to overcome suffering. People like Victor Frankl have suffered more than most of us ever will in our comfortable suburban ‘Hells’. He had the misfortune of being born on the wrong side of Aryan in Germany. The Nazi’s would force him to abort his child with his wife. He would also lose his wife, parents and brother to the concentration camps in Nazi Germany. Despite this he survived the camps and continued with his life’s work as a psychologist. Developing and applying what he called Logotherapy. A psychological treatment which posited meaning as its central theme. Perhaps it’s a naive opinion but when a man like this has something to say, I think we should listen.

I won’t quote the entire book, ‘Man’s Search for Meaning’. But If you haven’t read it I suggest you do so, like now! Ill distill out three quotes which stood out for me whilst lying in a hospital bed broken both physically and psychologically.

“Life is not primarily a quest for pleasure, as Freud believed, or a quest for power, as Alfred Adler taught, but a quest for meaning.” Viktor Frankl

“There are three main avenues on which one arrives at meaning in life. The first is by creating a work or doing a deed. The second is by experiencing something or encountering someone; in other words, meaning can be found not only in work but also in love. Most important, however, is the third avenue to meaning in life: even the helpless victim of a hopeless situation, facing a fate he cannot change, may rise above himself, may grow beyond himself, and by so doing change himself.” Viktor Frankl

“There are situations in which one is cut off from the opportunity to do one’s work or enjoy one’s life; but what can never be ruled out is the unavoidability of suffering. In accepting this challenge to suffer bravely, life has a meaning up to the last moment, and it retains this meaning literally to the end.” Viktor Frankl

Life is about meaning. Without meaning we are lost. It is the thing that sustains us a humans, not value, not power, not hedonism, but meaning. There are three main channels to find meaning in our lives: Love, Work and Suffering. The last is the only constant in our lives and as such the most important. There will always be suffering to overcome.

A brief introduction to Logotherapy.

Suffering is the Substrate of Life

We say that the only certainties in life are death and taxes. I think this is a poor attempt to hide the truth. Suffering is the only certainty. If you are born (and that is far from a certainty) you will suffer, it is unavoidable. Even those born in full health and with wealth of resource to spare will fall ill and die. That’s not accounting for their peculiar hardships that they may suffer. To disregard this truth is what the core of religion describes as the path to Hell.

I am not well schooled in Buddhism but I think that the Four Noble Truths and the Eightfold Path are one of the best summaries of the fabric and meaning of life I have ever come across (believe me I’ve searched). The Four Noble Truths are:

  1. The Truth of Suffering
  2. The Truth of the Cause of Suffering
  3. The Truth of the End of Suffering
  4. The Truth of the Path That Leads to the End of Suffering

If we accept that: There is suffering. That it is essentially caused by Life or Being itself (to be specific, this differs from Buddhism a bit here but the idea is similar I think). That there is a way in which we can end that suffering without the cessation of Life or Being itself. Then the means by which we do so becomes the meaning in our lives.

Suffering is embedded in Life and transcending that suffering is the ultimate purpose of life. This is the fabric of Life, it is the substrate from which our conscious experience emerges.

Somewhat Simplistic but it covers the all the point succinctly.

The Last of my Freedoms

“The last of the human freedoms: to choose one’s attitude in any given set of circumstances, to choose one’s own way. And there were always choices to make. Every day, every hour, offered the opportunity to make a decision, a decision which determined whether you would or would not submit to those powers which threatened to rob you of your very self, your inner freedom; which determined whether or not you become the plaything to circumstance, renouncing freedom and dignity…” Viktor Frankl

Lying broken in a hospital bed unable to climb, walk in the mountains with my dogs, feed myself, or even move without pain, I still had the freedom to choose. My love of life had been stolen from me by suffering. My passionate work to improve myself in the realm of rock climbing had been destroyed by suffering. But at least I still had suffering. Whilst reading Frankl’s words, I listened. As I had in ICU, I again chose to embrace that suffering, to find meaning. Before transferring to the rehab facility I did know how the journey upwards would go, but I took the first step in Vincent Pallotti Hospital. I laid down a foundational phrase which would help me rebuild my life in the dark times ahead.

When faced with Unavoidable Suffering, Suffer Bravely

This wasn’t quite what I was thinking at the time, but it certainly illustrates the freedom of choice in the face of suffering

Episode 6: A New Hope – The Taylor Spatial Frame

This X-Ray was taken about two weeks after the surgery to install the Taylor Space Frame. It was a stark reminder of how my life had changed. Photo by JM Watson

The Last Days at Christian Barnard Hospital

The bottom is an ugly place, but that is not to say that it is not useful to reach it. When I awoke on Friday morning, frustrated, in extreme discomfort and emotionally depleted, I knew that I had indeed reached the bottom. I also knew that there was utility in that and I felt just slightly better for it. Although the day was no less grinding, I did meet with Dr Laubser who would install the Taylor Spatial Frame (TSF) around my leg. Finally it felt as if I was moving again, impossibly raising my head to breathe after drowning in chaos and despair.

He informed me that I would be able to bend my knee and weight bear post surgery. I would also not need to stay in hospital whilst the bones healed. Something which was not certain in my mind and a huge relief. I would be transferred to a rehab facility after about a week of observation and healing in the hospital. There they would help me to regain enough functionality to be released from hospital with the TSF. Exactly how long that would take or in what condition I would be was unclear. But at last there was hope and a foreseeable end to the hospital stay.

The next few days passed like decades. The same routine of early mornings, physio and doctors visits punctuated long hours of attempting to entertain myself by reading, watching YouTube and generally being an emotional mess. I wasn’t sleeping much better. I was, however, able to get a few patchy hours each night which helped. They transferred me to a private ward due to an infectious pathogen they had found in the tests they routinely did. The doctors said it wasn’t infecting my wounds but needed to isolate me from other patients.

The visits from my mother, sister, brother-in-law and friends sustained me, keeping my mind in check in the otherwise endless hours of neon lights and immobility.

The Taylor Spatial Frame Surgery

I transferred to Vincent Pallotti on Wednesday afternoon. Thursday Morning was an anxious time waiting for the surgery that afternoon. I knew I would be going back into a more painful state after the surgery. It meant more IV drugs and altered consciousness. The confused state precipitated by the drugs combined with the massive psychological trauma was not conducive to sanity. It took everything I had to hold on in those periods.

The Surgery was a long one and waking up in the recovery area was as confusing and unpleasant as I could possibly have imagined. I phased in and out several times before stabilising and I was in considerable pain. I could feel the same fractalization of reality between bouts of lucidity as I had when they gave me the Ketamine. Again I found the words of Dr Peterson useful: Shorten your timeframe. I tried to breathe and make it through each second. Not fully aware of where or at times even who I was.

My first view of the TSF, relieved to have the other ex-fix removed. Photo by JM Watson

My mother and sister were in the ward when I arrived, I was in considerable pain. The anesthetist had given me a PCA. It’s a large plastic syringe like pump that allowed me to self administer IV painkillers every seven minutes. This alleviated the pain somewhat but at the cost of lucidity. The pain would rise and I would push the plunger. Several seconds later I could feel my consciousness narrowing and be sucked back into the fractal world beyond. The struggle was real.

An X-Ray taken a few days later, the shattered bone and the screws holding it in place clearly visible. Photo by JM Watson

Hope, and Desperation Post Surgery

Surprisingly I slept quite well that night, but awoke feeling exhausted. Dr Laubser informed me that the surgery was a success in his eyes. A relief but it did nothing for the pain. The first physio session was unnerving to say the least. Bending the knee after almost 6 weeks of it being stationary was an uneasy feeling. It felt as though the whole knee was in a vice grip and it was more than i could bear to feel all the wires and pins inside me. I politely asked to end the session and subsequently broke down crying when the physio left. I felt stretched beyond what I could handle by the end of the day. Music helped to alleviate the burden of being until the sketchy sleep covered me.

The pain improved over the next few days but not by much. I was barely able to move around in the bed. Sunday was the next day with anything other than the routine of hospital life and visits from family and friends. The doctor cut away the protective bandage covering the TSF and I could see it for the first time. As always the sight seemed both shocking and intriguing at once. This thing before me, both biological and mechanical is what was left of the the leg that held a heel hook on Human Energy, a toe hook on Born into Struggle and hiked countless kilometers into mountains unknown. Now I could barely move it and not at all without pain.

Top view of the STF. Photo by JM Watson
The marks drawn on my knee helped the doctors align the TSF. Photo by JM Watson

The nurses also changed the bandages on the wounds still healing between the Meccano set and replaced the sponges around the pin sites (something I would later do each week on my own). Later that day the physio would help me move the leg over the edge of the bed and slowly lower the foot to the floor. The pain and discomfort was real. I was only able to sustain that for several seconds. I had touched the floor for the first time since the accident, a momentous milestone.

Dressing change. Photo by JM Watson

Dr Laubser also started the adjustment of the TSF, a process which would continue for 5 days. The support struts of the TSF which join the two rings together have a locking screw mechanism that allows them to be lengthened or shortened. A computer program determines the correct sequence of adjustments needed to correctly position the rings to align the bone shards. The movement is spread out over 5 days to lessen the pain and allow the body some time to adapt before the next adjustment. Whilst the adjustment wasn’t painful, it did precipitate more inflammation. I felt more pain at the end of the day after the adjustments.

The next few days passed much the same. The pain did begin to lessen and I moved away from the trippy drugs, thankfully. I did my first stand heavily assisted by the physio and with all my weight through my arms on a walking frame. I was only able to do one stand the first day. Progressively adding two more the next day and three the day after that. The journey back to the mountains seemed impossible. I was still in a dour mood for the week after the surgery, despite the progress and the hope it had brought.

My first touch of the floor for about 6 weeks. Photo by Lyal (Thank God for that guy)

The Last days at Vincent Pallotti Hospital

By the weekend I had recovered a bit more, I was in a lighter mood when My birthday came. I ate burgers with my mother and sister and although I was still distraught, I was eager for the transfer to the Rehab facility.

Love had been lost and purpose had been expunged from my life, all that was left now was suffering. Thankfully I had asked for a copy of Mans Search for Meaning by Viktor Frankl, which I had intended to read whilst in Rocklands. His words brought some dignity back to my mind and remembered in me some of the thoughts which I had cultivated over the few years prior.

” When faced with unavoidable suffering, suffer bravely” Viktor Frankl

Damn how I tried, through the tears and the pain. Looking back on that period I understand that I succeeded in rekindling hope. At the time, however, I could not see the forest for the trees. The forest had apparently seen me and was preparing the reveal itself. After spending a week and two days in hospital post surgery, I would transfer to rehab on Monday the 26th of August.