(This is a transcript of a podcast, available here.)
In early March of 2006, I had a very unpleasant experience, and I believe it may turn out to be a life-altering experience. It certainly has had a profound affect on my life since it happened.
I had an attack of vertigo—it wasn’t the first time—but it’s been several months since I had my first and second attacks, which came pretty close together.
The first time I had it my wife and I were camping in the Sierras in our camper van. I woke up in the early morning, turned my head, and the world started spinning. I found that if I kept my head in a particular orientation the spinning would gradually subside, but that every time I changed position the spinning began again. As a result I experienced profound nausea. I didn’t actually throw up, because I would immediately freeze the position of my head until the vertigo stabilized. It gradually diminished during the day and I was able to have a fairly normal day.
The next morning I woke up and it wasn’t quite as bad, but it was still very unsettling. Once I stood up and got used to it, I could walk around and function fairly normally, but if I bent over or changed the vertical alignment of my head, I went spinning off into the world of nausea.
It gradually got better over the next couple of days, but when I got back to civilization, I went to my general practitioner. First I did a little research on the web and found out what some of the possibilities were, and the worst-case scenario would be that a part of my brain had ceased to function normally. That seemed unlikely.
So I went to my doctor and he said, “It’s very common in people your age and older. I’ve had it; my wife’s had it, and it goes away. There are a couple of possible causes. One of the most likely, perhaps, is that there are these little hairs in your inner ear, in the semicircular canal, that are immersed in liquid, and when you move, the liquid moves, and the hairs move. They transmit information to the brain, which then uses that information to orient itself in space. A couple things can happen. One of those little hairs can break off and start rattling around in there sending spurious information to the brain, or particles may coalesce out of the liquid, and they’ll rattle around and cause the same phenomenon.”
It’s something that’s common the older that you get—okay, I’m 62, in case you’ve forgotten—I’m 62, and the older you get the more common it gets. In fact, they did a test with people who were in their 80s, took them out on the ocean in a fishing boat, and none of them got seasick, because their vestibular function had been so altered through cumulative defects of this sort, they didn’t have nausea. Well, that would be a positive effect; I wouldn’t mind that so badly. The brain finds other ways to orient itself in the absence of the vestibular information.
But in the meantime, it’s not very pleasant the first time it happens. It’s very disorienting, and confusing, and alarming even, because it’s very difficult to function for awhile. There are lots of symptoms of illness that I tolerate fairly well, but the one I probably tolerate least well is nausea. It’s very uncomfortable.
This last episode I had, I woke up in the middle of the night. I live alone now, so there was no one here but me. I knew immediately what was going on. I did what my doctor had told me to do last time, which had been very effective, and I took anti-nausea medication, Dramamine or Bonine. The 24-hour kind is less troublesome; you take one pill a day and your nausea pretty much goes away, because it anesthetizes the vestibular function. I took a pill about 2:30 in the morning and woke up about 7:30, I suppose, and began my daily routine—or tried to begin my daily routine—and found that the nausea had not been relieved. I didn’t expect the vertigo to be gone, but I had hoped that the nausea at least would be gone. It wasn’t. So I took another pill. The dosage is one or two. I took another pill and then waited and hoped it would take affect.
In the meantime my gut felt so unpleasant that I had the thought that I would rather die than go through this. It wasn’t a terribly persistent thought, and I remembered a saying I had heard in Alcoholics Anonymous, that suicide is a permanent solution to a temporary problem. I reassured myself that surely this would go away. I would not be nauseous for the rest of my life, and there would be good times ahead if I could just hang in. The rest of that morning there was improvement, but I was not only nauseous, I was very weak, and it could be that I had a mild case of food poisoning. It could be that there was some association between food poisoning and this vertigo that I had.
At any rate, I had difficulty preparing something to eat and then eating it. I felt weak and very debilitated, which was different than the first time I had had it.
So enough of the nauseating and unpleasant symptoms, at least the physical symptoms—there were psychological symptoms as well.
That day I spent most of the day napping in my chair. I tried to stay fairly vertical so that I wouldn’t have to adjust so radically when I stood up to go to the bathroom or get something else to eat. I napped in my chair, and it gradually got better during the day. The next day it was pretty much gone, largely gone, but I still felt not myself. I took another anti-nausea pill—just one—and that got me through the day without feeling like I was going to throw up, but it was not one of my better days. I spent most of the day sitting around reading and napping again.
Psychologically I was depressed. The day after that I was even more depressed. I felt better, physically, but there was the thought—the recurring, the persistent thought—that this was going to get worse. I spent part of the second day online, reading accounts of other people’s experience with vertigo and with what’s called Ménière’s Syndrome. Some of the accounts were much worse than anything I had experienced, but at the same time, people had had progressively worse experiences. Even if I didn’t have progressively worse experiences, the indications were certainly that I would have more experiences at some unpredictable time in the future, that my life stretching ahead of me was going to be marked here and there by episodes of this illness.
Considering how unpleasant it was, and how depressed I had been … I’m not usually a depressed person. I may have tendencies to be depressed, but I have developed … I have learned, I have evolved a set of processes that work with the small-scale downs that I encounter occasionally. But the techniques that evolved with me were ineffective in the current situation. I felt that if I was going to have more of these, then I had to take some sort of preparatory action. You might well wonder—as I did at first—what sort of preparatory action one could take.
What I came up with was based on my experience with the physical limitations I had experienced earlier in life, that I had developed a strategy for dealing with. Back when I was first beginning to smoke pot a lot, I found that … what I most liked to do was get stoned, turn on the stereo, sit on the sofa, and stare out the window. We happened to have a house then, in Oregon, that had a beautiful view out the back window, off a deck. It was naturally wooded, just like being in the middle of the woods in Oregon, in a cabin—except we were in fact on the edge of Eugene. It was a beautiful scene to look out on, and I would spend hours stoned, listening to music, looking out the window, and just drifting. If you do that long enough what happens is, that your muscle tone decreases and your muscles atrophy. If you did it long enough you would get to the point that you couldn’t get off the sofa, or barely get off the sofa, because your body will only maintain the kind of musculature and muscle tone that you require of it—if it doesn’t need it, it’s going to dismantle it.
I acquired limitations that I only realized when a friend came over and said, “Hey, let’s go up to the hot springs—Cougar Reservoir.” It sounded like a fun thing to do. It’s a short hike back into the woods, and it’s like hippie fairyland; there are beautiful ferns, huge trees—forest. This hot springs just bubbles up out of a crevice in the rock, and people have dammed it up so that as it flows downhill there’s a succession of pools. They’re not very deep, but you can lie in them and it’s nice and hot. In Oregon any time of year it’s rarely too hot to get in the hot spring. Well, in the summertime it could be too hot.
The other benefit of this particular location was that a short way down the hill it encountered a cold stream—a larger cold stream. Shortly uphill from the intersection was a waterfall. This whole place was just idyllic; a beautiful place to go. Now, you have to pay to park out on the road and then hike in, but in those days there was just a wide place in the road; you pulled over, and you could stay as long as you like. You could spend the night, or whatever. So things change.
At any rate, we got up there and I found that the short hike back to the hot springs was a struggle for me; it took much more effort than it should have. I felt much more drained and much less capable, and I thought, “Well, this lying around looking out the window doesn’t prepare one for much activity in the outside world.” I realized that I was either going to have to accept the limitations of my deteriorating condition, or I was going to have to get in better shape to increase my recreational opportunities—that was the beginning. Actually, in high school I had been enthusiastic about getting in shape for awhile, and then I was in the Air Force and we had some physical training, but I had drifted out of it.
So I got back into it. First in Oregon, jogging, and later on going to the gym, until it got to be a thing I did, like brushing my teeth—it’s body maintenance. If you want to keep your options in the physical world open, then you have to maintain a certain level of physical conditioning. It’s been very rewarding; I can do almost anything that it occurs to me to do. I can put on a pack and hike out into the woods carrying a heavy tripod and a camera and not be too much the worse for it. It’s become a way of life.
Thinking of that, and how well it has worked out for me over the years, I thought that I probably needed to develop some mental muscle against the future occurrence of these episodes—because they were definitely going to recur—but how does one prepare oneself mentally? How does one develop mental muscle or psychological tone—whatever the equivalent term would be?
Having spent some years studying Zen, I have also spent some time in meditation. I was aware that part of the appeal of Zen—or meditation of any sort—is that one is better prepared to deal with the difficulties of life. There is a whole program that’s been developed around stress and pain management, and that’s been adopted by some very straightforward and conventional medical institutions—Kaiser, for one, here in California, has a program. The idea is that people can get off medications or decrease the amount of medication that they use. They can feel better with less conventional intervention, which of course helps Kaiser’s bottom line, and helps the people as well.
So I knew about that; I knew that was a possibility. I had done some meditation over the years, but never very consistently and never very long-term. I decided, facing a future that was coming to seem very likely, that perhaps it was time to get serious. And so I have been. I’ve been doing fairly conventional meditation practice; sitting and counting my breath, watching my breath, returning to watching my breath whenever my mind wanders, which of course it does. Since I had had some experience with that before, it wasn’t a totally strange activity. At the same time it was a little like drudgery; it wasn’t that much fun. It wasn’t that interesting or exciting.
Until it occurred to me—just yesterday, as a matter of fact—and perhaps … I would like to wait longer before I told you about this, because I’m not sure how it’s going to play out, but I’m going out of town in about a week, and I’ll be gone for a couple of weeks. I thought, well, I’ll go ahead and do this podcast, and it may work better for some of you than it works for me—I don’t know, in the long run; hopefully it’s going to work for me—to give you that as an option, because one thing all of us are going to encounter sooner or later is the gradual deterioration of our bodies. No matter what we do, if we’re lucky enough to live to, say, the age of my parents—my dad is 89, my mom is 84—your body deteriorates, and there are certain things you can do, a certain amount of precaution you can take, but inevitably, if you survive you are going to have problems. In the meantime, there are all sorts of contagious illnesses you can get, and accidents you can have. The highways are a deathtrap, and … a source of injuries, and long-term disabilities, that is going to be around. For anybody that’s out there, life is destined to become more difficult.
Anyone may have occasion at some point in their life to think that some sort of psychological strategy for dealing with stress, pain, and emotional discomfort of one kind of another, would be a good thing to have. I can’t offer myself as an example of how well it works—I’ll have to wait until the next time I have an attack of vertigo to tell you whether or not my ability to handle such situations has improved—but in the meantime, I found a way to make medication much more interesting.
It occurred to me yesterday after dinner. I had a crepe at Kareem’s place on Lakeshore; if you’re ever in the area it’s a great place. He’s French and the food is excellent. Afterwards I took a walk down by the lake. It was about sunset, and I ended up on the edge of the lake facing downtown. It’s one of my favorite spots because the sunset is behind downtown, so there are shadows of the buildings on the water. Between the buildings are patches of reflected sunset, and the waves make these wonderful patterns of reflected shadow and sunset as the angle of the waves changes. It’s very fascinating.
Something I have learned to do, looking at that sort of natural phenomenon—one of my favorite things to do, really, dating back to pot and acid days—is to turn off the verbal commentary that usually goes on in my head. The visual experience becomes much more interesting. It’s a case of trying to do two things at once and doing neither one very well: if you’re looking at something, and at the same time your brain is running verbal commentary on it, you can’t experience the optical sensation with the same level of intensity that you can if you marshal more mental resources on its behalf; you’re distracted by the conversation. This is something that I have gotten fairly good at; I can do it for fairly long stretches of time. It’s a form of meditation, but I’ve never found a way to translate that into more mundane circumstances. I have never experienced that same sort of rapture and euphoria sitting at home, and I wondered why.
I came upon a way of thinking about it that I’ve tried a little bit since. Like this morning, and for a good bit of the day today, it’s been possible for me to apply this technique, which is very exciting and has a lot of potential, I think. It certainly made my meditation this morning more interesting. It involves regarding what’s going on in my body and brain with the same kind of verbal detachment that I can muster when I’m looking at an interesting visual scene. It brings to mind this phrase that you hear in Buddhism and Zen, in which they talk about seeing a thing as it is. Of course the reality is that we can’t see anything as it is; in fact, there have been some Zen guys who knew that, and they were considered very cool. One of them—I think his name was Pai-chang—said that when you realize your senses are not connected to reality you are practically there.
That’s something we can certainly understand from a scientific point of view, because visually our perceptual system only responds to limited wavelengths. If we were able to respond to other wavelengths with the same sensitivity that we can respond to what we call visible light—what a surprise; the wavelengths we can see are called visible light—and things we can’t see are, of course, invisible. We can’t see infrared or ultraviolet, but if we could, we would see an aspect of the world that is now invisible to us. We would come closer to seeing things as they are if we got more information in terms of electromagnetic wavelengths.
Say, for example, that we had some way of responding to the gravitational effects of something as small as a wave or a ripple. It’s a little difficult to imagine what sort of sensation that would be, but it’s possible to imagine we could respond to it in the same way that we respond to the way an object reflects light. Then we would certainly have a different perception of that object and would have more information about it. We would come closer to seeing the thing as it is.
We have learned—with instruments and so forth—that something as simple as water has a whole chemistry that we can’t monitor at a distance. We can see the visual effects of surface tension, but we can’t experience that except by touch—and of course we can’t experience that at a distance either. No matter how sensitive we might become to the physical aspects of an object, there would always be many senses in which we would not be perceiving the object in its full range of natural characteristics.
To say that we see a thing as it is, is always going to be a kind of shorthand; it’s not going to be an accurate representation of what’s happening. But what I think is an accurate representation is to say that we would more accurately or more fully perceive those aspects of it that our perceptual system is capable of, if our attention were focused more completely on that thing.
So I am going to use that term as a kind of shorthand. Keep in mind that I realize it’s not an accurate term, but I’m going to talk about looking at a thing as it is as shorthand for saying, looking at a thing without verbal accompaniment, without the range of verbal associations that we might have.
Typically, if I look at a scene like I did last night, I’ll think about the photographic possibilities and the settings I would have to make on my camera, and whether or not it would be able to register the full dynamic range. You might think of some time in the past when you were in that sort of environment and the experience you had then. Or you might think about some future time that you might be in such an environment and you’d have a friend with you, and how you would talk about the situation or the experience you were having. There are all sorts of verbal ways one can get involved in a scene. To cut those off and isolate our attention to the physical sensations gives us a larger number of neurons to bring to play in perceiving the situation.
I transferred that understanding of the way I could focus on a visual experience like the ripples on the water, by realizing that I could look at the sensations within my own body with that same kind of verbal detachment. Rather than feeling like my foot is in a particular position, or I’m getting certain sensations in my shoulders or neck—specifically with the word “my” attached to all these perceptions—if I remove that possessive, and just look at these sensations as sensations that were being experienced in the same way I was experiencing the waves on the ocean or the ripples on the lake, then I had a similarly heightened sense of those perceptual experiences.
The next step, which is a bit more difficult, I think, is to look at the things that emerge in our brains with the same kind of detachment as something that is happening in experience, but without the intervention of the self. The things that we experience in our conscious awareness are the result of a whole lot of processing—they get labeled as being the experience of the self and the function of the brain. Of course they are the function of the brain with which my self is associated, but my conscious awareness doesn’t have anything to do with choosing what becomes conscious.
What I think might happen if one pursues this sort of experience, is that the sense of one’s mental activity belonging to the self will decrease. Even in the short interval that I’ve been playing with this idea—just today—I have found myself walking around my apartment with a new sensitivity, a new point of view toward my movement through space, and my thoughts as I proceed through the day.
Ideally what will happen is that over time the illusion of the self that I’ve talked about in earlier episodes will be eroded, and my experience of life will be more in keeping with the reality that we have learned about in our study of the brain and how it works. As my experience of life becomes more attuned to reality, more in keeping with reality, then as the circumstances of life change, hopefully I will be better able to adapt to those changes, as inevitably, changes will come.
To put that in concrete terms, I think my recent depression over the vertigo was due to the fact that I had an image of myself, and an image of what is involved in my having a happy life, that was disrupted. My idea of a happy life is a life without vertigo, without nausea, without food poisoning, or any other ill, or deterioration of any of my functions. That, ideally, is the kind of life I would like to have, but it’s not in the cards.
If I can develop a perception of myself, and of life, that is less dependent on a particular set of circumstances—more flexible, more attuned to the reality of the changes in life that are inevitable—then hopefully the next time one of these unfortunate experiences arises, I will deal with it with much more equanimity. It will be something that’s expected and prepared for. I hope that’s the case. I’ll certainly let you know if I have any success or further failures in this regard.
Update, May 27, 2014:
I have not had an attack of vertigo since the one in 2006, and maybe that’s just my good luck, but I ran across some anecdotal evidence at that time that ginkgo biloba might help, and I’ve been taking 120 mg twice a day ever since. I’m not sure whether that has been a factor or not, but it’s fairly cheap and harmless as far as I know.
Another thing that has helped friends of mine is the Epley maneuver. The link will take you to search results on YouTube, where there are several demonstrations.