Sugar Water For My Dopamine-Depleted Brain, featuring George Saunders

The importance of dopamine became apparent in 1954 when the neuroscientists James Olds and Peter Milner ran an experiment that revealed the neurological processes behind craving and desire. By implanting electrodes in the brains of rats, the researchers blocked the release of dopamine. To the surprise of the scientists, the rats lost all will to live. They wouldn’t eat. they wouldn’t have sex. They didn’t crave anything. Within a few days the animals died of thirst.

In follow-up studies, other scientist also inhibited the dopamine-releasing parts of the brain, but this time, they squirted little droplets of sugar into the mouths of the dopamine-depleted rats. Their little rat faces lit up with pleasurable grins from the tasty substance. Even though dopamine was blocked, they liked the sugar just as much as before; they just didn’t want it anymore. The ability to experience pleasure remained, but without dopamine, desire died. And without desire, action stopped.

James Clear, Atomic Habits (p. 105)

Although I’m happily emerging from the slump, for much of this year to this point, I found myself relating to the rats described above, in that I had very little desire to do much of anything. Although this sounds like—and probably was—a classic depression symptom, I simultaneously observed that, like the rats, I didn’t feel particularly unhappy. I still enjoyed flowers and pretty scenery and conversations and food when—like sugar water getting dropped on the rats’ tongues—it was delivered to me with minimal effort on my part. Luckily, because I live with a man who is moved by his own appetites, much of the world is delivered to me: Marvel television programs appear on the screen, food arrives, I am ferried to various destinations. And as these things happened during this time, I thought mmmm, riding in the car in the sun is nice, this view is nice, this Modern Kale Ceasar Salad hits the spot.

The one arena where Paul could not do much for me was in my writing. With a kind of distanced concern, I observed that my sense of hope and ambition for my writing career had disappeared, and my desire to actually write had dwindled to almost nothing. This, more than anything else, highlighted for me the growing similarity between myself and the desire-less rats. I thought,

For most of my life I have cared about writing. While I don’t care right now, it seems probably that I will care again in the future so it makes sense that I should try to prolong my creative life until the caring kicks back in. To that end, maybe I should attempt to be not only the rats, but also play the role of scientists. (Not the scientists who let their rats die of starvation, but the ones who provided sugar water to keep the rats alive, albeit after cruelly disrupting their normal dopamine flow.)

In other words, I needed to procure my own source of sugar water.

I set about doing this by signing up for a session of the weekly writing workshop I sometimes do. It didn’t push me into writing pages as it normally would, but my sense of social obligation drove me to read other people’s work and give decent notes. There was some satisfaction in realizing that, after years of practice, seeking writing solutions when I read scripts is now as automatic as starting to chew after I’ve put food in my mouth. So I think my fellow writers benefitted and I exercised my brain a little. But after a couple of months, I was worn out even by this. I needed sugar water that required zero response.

Normally I keep a running list of the “content” I am watching and listening to, but I also didn’t care enough to do that. Much of what I was consumed was apparently not memorable, but I’ll mention a couple that were:

On Apple TV, there was Severance. Rather than attempt to say much about it, I’ll just recommend it, or recommend reading the second half of this essay in Electric Literature. (Or, like me, you could read the entire essay and then order the book that it talks about in the first half.)

On audio, there was the George Saunders’ book, A Fish in a Pond in the Rain.

In the first weeks after my surgery, my general I-can’t-make-myself-care mood persisted, mixed with a fair amount of physical pain.

“Are you okay?” asked our most curious neighbor, with some actual concern.

I was not great. I had little energy or desire to have back-and-forth conversations or observe the social niceties of stretching my face into different expressions. But as I slowly shuffled around the block like a battery-finally-depleted energizer bunny, A Swim in a Pond in the Rain was pure sugar water piped into my brain via my ears. Inside my head, and even inside my soul, “my little rat face lit up with pleasure.”

Although the book can be described as about writing, Saunders also weaves some discussion of morality, spirituality, human nature and the general poignant ridiculousness of people.

Saunders, like my husband, is an engineer-turned-writer, and it is interesting to observe the ways in which their minds think alike. Saunders elevates this by also being well-read and dedicated to efficiently and affectingly articulating his thoughts that are shaped by years of consideration and teaching.

In each section an actor reads a story by a Russian author you’ve heard of, and then Saunders analyzes each story, beat by beat, page by page, doing both a close reading,” and a larger structural analysis.

If you are a writer, a reader or a lover of stories, I highly recommend this book.

P.S. Though I’m a fan of George Saunders’ fiction, I became aware of A Swim in a Pond in the Rain via his Story Club newsletter which you can check out on SUBSTACK for free. I will admit to being months behind — apparently opening emails and reading things on my computer is less like sugar-water delivery and more akin to having to cross one’s cage for sustenance, and I’m not all the way there yet. The minute he compiles his posts into an audiobook or podcast, I will be the first to lay my money down.

Introducing ATOMIC HABITS

Quick health update: I’m almost six weeks out from my surgery and feeling much better. Some aches and pains will work themselves out for a few months and deep healing is a process, but, as of now, no more daily needles in my belly, the glue is slowly peeling off the wounds, and I wake in the morning with more energy…

So… cool! I guess that means I can get back to what I was doing I when I got distracted, like…. six months ago? What was I doing again?

Oh, right, planning my best life ever in 2022! 😹

As 2021 came to a close, I decided to build the new year around two books: Joy at Work, co-authored by Marie Kondo, and Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones by James Clear. My plan was to pre-read these books before the end of 2021, then, in the new year, to go back through them in a more active way, using the advice and doing the exercises until I emerged anew— organized, in control, productive and operating at maximum satisfaction.

Of course, I understood that reconfiguring a lifetime of not-great habits wouldn’t be quick. It might take all year! Though, secretly, I hoped for less. Maybe I would achieve my optimal life in half that time—like by June, or even May!

Hahahahahahaha.

God

Consider this a prequel to some upcoming posts wherein I will reference Atomic Habits in the context of ruminating about life and purpose.

Ups and Downs

(Second week after a full colectomy.)

Recovery— or I guess life— has its ups and downs.

The first rosy flush of “up” in my last post was followed by a couple days of down — of pain not diminishing as quickly as I hoped (or becoming less masked as I tapered back on the meds), of mysterious bruises and swellings that are probably normal and not worth a call to the doctor but the source of niggling worry because what if they are not?

And also the sadness of coming face-to-face emotionally with what I already knew logically — that surgery is crest of a hill but not the end of the journey. This goes beyond my physical recovery. I haven’t really gone into the details of how, in these past months I’ve struggled with focus and direction in my creative / career efforts, but at the same time allowed for the fact that the health situation would have me reasonably, distracted! And I’ve hoped that as I move past my issues of health, there will be a moment when I’ll again feel the desire to finish any of a dozen unfinished projects — and even the hope that one project will call to me louder than the others, providing a clarity I’ve been sorely lacking. Of course, rationally, I knew it was unrealistic to expect that this desire and certainty would descend upon in my in my first days home from the hospital, but irrationally, I was still disappointed that they didn’t.

But after a day or so, the mystery swelling went down in my body and I decided I could be gentler with myself in spirit. After a week of convalescence with my mom I headed home with Paul and we had a really nice Easter with family where I was feeling good. The next day, I received word that the pathology report for my surgery was back:

NO LYMPH NODES INVOLVE, NO CHEMO!

Which is, of course, great news.

I returned to a standing weekly client meeting, and feeling frisky, even shot off some emails, feeling cocky, yes, I know it’s less than two weeks, but energetically, I’m past it, it’s downhill from here!

And then on Tuesday afternoon, I got hit by a mysterious new pain, between and under my ribs. It was alarming in that it was sharper, and in a different location than any previous post-surgical pain — but I know from experience that even the most dire-feeling Am-I-having-a-heart-attack? Am-I-dying?? pains are usually just “trapped gas.” Knowing this, I went outside to “walk it off,” only to return, defeated, after only half a block. I spent Tuesday night and Wednesday day and night curled around a hot water bottle.

But, now it’s Thursday morning and though I’m not 100%, the pain has subsided and shifted in a way that supports the idea that yes — even though I paged my doctor and considering the emergency room at one point — it was likely was just trapped gas that is running its course, if not so quickly as I may wish. There’s also a chance that this episode may be the first in a series known as “the new normal”— a non-serious but painful pain, that, as it comes and goes, will need to be analyzed (did I eat the wrong thing, or too quickly, or in the wrong order?), and ultimately incorporated—ie. balanced and juggled—along with the rest of life.

“Balancing and juggling” feels thematically appropriate to a tarot card I pulled last night. (Very recently I’ve been introduced to tarot cards, and have been drawing a card each morning and evening, not as prophesy, but as a way to learn the cards and think about life.) I drew the Two of Pentacles.

Also called “The Juggler,” the Two of Pentacles is about trying to keep all our earthly balls in the air— work, family, money, projects, food, clothing, shelter etc. And, of course, holding our temporary bodies together for as long as we can while we’re here!

I think I have a lot in common with the dude pictured on this card: We’re both running a little to stay underneath those “infinite” balls that we’re juggling or balancing— or both. Our shoes don’t match, but at least we’ve got some on — even if the same can’t be said for pants! Our boats rock on topsy, turvy, turbulent seas, but they’re still upright and moving forward. Sure, it all feels a little precarious, but somehow, nothing’s crashing to the ground. Maybe because we’ve both had some practice with boats and balls and waves all moving up and down, and understand that, tiring as it can be, there’s some fun in doing the dance, seeing how long we can keep it all going!

So Far, So Good – Post-Op Report

(Getting a full colectomy, and the first days of recovery.)

Last Thursday we woke up bright and early… or dark and early I guess, since the sun wasn’t up at 3:45 am. I took my last shower with special anti-germ chlorhexidine soap, and we headed to the UCLA Ronald Reagan Medical Center for my 5am check-in.

There’s a conveyer belt of pre-surgery rituals: I signed in at an admin area then reported to a curtained pre-op room, where a nurse handed us packets with six pre-soaked chlorhexidine wipes and instruction sheet for wiping my entire body down again, as well as special swabs to clean out each nostril (not a Covid thing, apparently, just standard). I changed into a hospital gown, reassured multiple folks that there was no chance I was pregnant, signed consent forms and got hooked up to an IV. Everyone was very kind and nice. The “team” all introduced themselves, etc. A second surgeon working with my surgeon reassured me that their surgery plan prioritized two things: 1) a successful operation that would remove any cancer, and 2) preserving as much as possible of my colon, per my request.

Then they wheeled me in to the operating room. I wanted to to see the “robotic” equipment, since my surgery was to be robotic if needed. It was a little disappointing because the arms were retracted, and there weren’t any Transformer-looking appendages—which makes sense as they probably keep those sanitized and wrapped until the very last moment. But here’s a couple of images stolen from the internet of what things might have looked like after I was knocked out:

Then the drugs hit my bloodstream and I was out. I woke up in recovery later in the afternoon, and was very happy to hear that the surgery had gone smoothly: They were able to do the surgery laparoscopically (as opposed to open) and had been able to keep about six inches of my sigmoid colon.

A few other interesting (to me) details: 1) Along with having (had) a longer-than-normal sigmoid colon, I also have a slightly longer-that-normal rectum. I’m hopeful that this extra length will be helpful as my body adjusts to its new normal functioning. 2) During my first surgery, in Australia, years ago, the surgeons opted to make the small-to-large-intestine connection (the anastomosis) behind my stomach, which is apparently quite unusual. This made the present-day surgery a little longer and more complicated for my doctors, as they had to reach around behind the stomach to do some of their work.

I stayed the night in the hospital and was able to have some visitors, like Paul, my mom and my brother. Everything was pretty painful, but I know how important it is to move in order to get my digestive system working again, so I ate some broth and and a bite of mashed potatoes, and got up to walk around the area, pushing my IV pole.

Currently, I’m at my mom’s apartment, enjoying the quiet, and the luxury of having food cooked and dishes taken away when I’m done. The first couple days was mostly pain management (Tylenol and Oxycodone), very slow walking and resting. But now I can (in limited fashion) read, write and watch TV in the evenings. For the next 4 weeks, I’m supposed to eat a low-fiber diet, which is pretty much the antithesis of everything I normally try to eat, i.e. meat, not veggies, white rice not brown, processed breads and crackers, not nuts or seeds or grains. I’m not supposed to lift more than five pounds or do abdominal exercises — even though I end up doing those inadvertently just getting in and out of bed. I asked my surgeon a litany of questions like, “can I sleep on my side? what if I twist around? can I lie on my stomach? can I do yoga?” and he pretty much said that it would take blunt force trauma to pull apart what has been sutured together. That doesn’t really jibe with the idea that lifting five pounds would be injurious… so as my energy returns I’ll have to figure out some of that out. For the moment, I’m happy to have other people do the lifting!

My least favorite part of the day is when I have to take an anti-coagulant medication called Lovenox —through a needle jammed into my belly! I’m lucky though, because instead of having to self-administer it, Paul does it for me—best husband ever! Apparently cancer patients are more prone to blood clots for longer than most people after surgery, so instead of two weeks, we’ll be doing the shots for 30 days.

For those who are waiting for the “poop report,” so far, there have been no toilet emergencies (though, TMI, my surgeons “oatmeal” example is proving apt)! At the moment, my entire digestive tract is recovering, and, somewhat counter-intuitively, I am taking a prescribed stool softener because the painkillers tend to slow everything down. I’ll have a better sense of my new normal as time goes by, but so far… so good!

Last Day With Colon

(On the last day before my full colectomy, I prepare for surgery)

Tomorrow is my colectomy. 

My surgery 20 years ago was what they call a “hemi-colectomy,” because it removed about half my colon. Some friends came to visit in the hospital back then and brought me a get well card adorned with a bold, graphic:

;

It was funny. I really enjoyed that. I don’t know what can graphically represent my situation after tomorrow. Maybe this? 

,

PREP DAY:

My pre-op prep started last night with a shower using a chlorhexadine soap that is supposed to block germ growth to prevent infection. After using it, you can’t use lotions or moisturizers, so I currently have elephant skin. I’ll take another shower today and another in the morning before we head to the hospital for our 5:00 AM call time.

For the rest of today my duties are: 1) Don’t eat any food that’s not transparent (which, since I’m too lazy to make yellow jello or clear broth, just means a water fast), 2) Take two kinds different antibiotics three times during the day, and 3) drink two bottles of magnesium citrate (which interestingly (to me) after 20 years of colonoscopy preps, I’ve never had before).

Halfway through this protocol, I can say that in terms of bitterness and nausea inducing qualities, one of the antibiotics is actually worse that the magnesium citrate, but we’re making it through. In between trips to the toilet, I’m prepping for convalescence, which is pretty much like prepping for a trip. Paying bills, set up an auto reply on my email, doing laundry and dishes and whatever tasks I’ve been putting off but now seem worth doing at the last minute. 

NEW VIDEO PROJECT

I’ve also been bossing Paul around, having him get some shots on his phone camera that I might be able to use later for one of the videos I have in my head. It’s possible that my newfound passion to do this YouTube / podcast thing is just my subconscious distracting me from the realities of the realities at hand, and my energy for the whole thing will be short-lived, but…

As threatened in my previous post, I recorded my first video yesterday! A video-version of my last post, “How often will I poop after a colectomy?

It was a good reminder of the joys of producing the simplest of projects. We got the camera and mic set up just in time for the tree cutters, leaf blowers and house remodelers to rise in chorus outside my office window. Once these noises tapered off toward evening, the young woman in the apartment downstairs came home with a girlfriend and they had a nice 3-hour gabfest in the room right below mine. I finally recorded anyway, with the rise and fall of their conversation — that distinct rhythm and lilt of two women in their early 20s — in the background. 

My initial takes were so rambling and disjointed that I ended up reading from script instead of looking into camera which I’m expecting to be weird and off-putting, but in the end I just loaded it onto the hard drive for “Future-Barrington-who-has-learned-how-to-edit” to deal with. The perfect is the enemy of the good enough, right? 

I’m sure Future-Barrington is going to be happy with … everything.

It’s fine. It’s all fine. I’m not worried at all!