Medicine Is Scary

There, I said it. That's what all this big, horrible, stupid natural movement is about.

Medicine is scary.

That's why people avoid vaccines. Because shots hurt and they make children cry and I don't understand them and THEY MUST BE BAD! That's why women are fleeing L&D wards in droves. Because surgery is scary and the reality of birth is scary and I would rather have someone lie to me and tell me it's normal and everything is going to be okay. It's why cancer patients seek out quacks. Because it's nice to hear that if I just eat right, my body can fight this thing all by itself and I don't have to do that chemo which hurts and makes me sick. And, that's why I'm delaying having my last wisdom tooth removed. Because it was really scary, it hurt really badly, I have some residual nerve damage, and it all around sucked the big one.

But that's not a rational decision. And, you know, I must say I have a big bone to pick with the rest of the atheist community. Humans are most definitely not rational creatures. We may be capable of reason on occasion, but it doesn't come easily. It's much more normal for us to grunt and squawk and shout and jump around and point at the fire.

But, back to teeth. In October I had two of my wisdom teeth removed. Top and bottom on the left side. The top one had decided to move suddenly and stab me in the cheek. It needed to go. The bottom one was severely impacted and needed to go, too, but less urgently. It also carried a greater risk of complications because of its level of impaction. The top one popped out easily. The bottom was half stuck in my jaw and required nearly an hour of prying and pushing and cracking and four injections of nerve block... all of this inside my open mouth.

I have TMJ. It usually doesn't give me a lot of problems. And then my dentist stood on my jaw for an hour. I couldn't open my mouth more than a centimeter for two weeks. And, somewhere along the line, either the nerve block or one of the extraction tools damaged the nerve and I have some residual numbness on the bottom left side of my mouth and tongue. After the procedure, I drove to the drugstore, which had failed to check their messages and hadn't filled my prescription for painkillers yet. I had to wait there for half an hour as my jaw woke up and I bled from this hole in the back of my head.

It was a horrible, awful, terrible, no good, very bad experience. It was also completely necessary.

I had a filling done on Tuesday. Now, fillings are easy peasy. This one took about half an hour all told if you don't count the various wait times in the process. EASY. I've had several. I've never had any problem. I have no dental phobia. But, the trauma of my experience with the extraction was still raw and I became very anxious during the first half of the procedure. This is completely normal. It didn't make it any less terrifying. I will be completing all my necessary dental work. And, eventually, I will have that last wisdom tooth removed.

But, this is an important point. That fear is normal, as I said. We evolved to have seriously negative reactions to what we perceive as dangerous situations. It keeps us safe. Unfortunately, we haven't yet developed appropriate responses to things that seem dangerous and scary, but are actually for our benefit. Medicine is a new thing in this corner of the universe. We've learned profound ways to heal ourselves and combat disease. But that doesn't change our response to what seems like (and really is) an injury, even when that injury's purpose is to help.

If I have a heart attack, I may die. But, if I can prevent a serious heart episode with surgery, I may live longer. That surgery carries many risks and is quite frightening, even if it is successful. If I were unlucky enough to experience it, through a failure of sedative, it would be very traumatic. (Why women volunteer to be awake for cesarean sections I'll NEVER UNDERSTAND.)

Procreation is very costly. And I'm not talking about that college fund or eighteen years of new sneakers. Placental vivipary has serious risks. There are lots of things that can go wrong, and it is with great fortune that successful species have persisted. Humans have big brains. Humans have -really- big brains. Sure, other hominids have had bigger brains, but ours are rather impressive. Our brains are so big that they have to start really big in order to make it. Great. Big. Tracts of... brains. This is, of course, complicated by our weird-ass hips and upright stance. Walking on two legs has made this whole big brain thing really complicated. So, we have really slim little squishy bodies that end in a couple holes and two spindly legs and we want to somehow push out a big-headed naked thing? Oh boy.

But it's not just birth that's at issue. The whole thing is a humongous accident waiting to happen. Thanks to the advent of the early pregnancy test (when my mother was born, no one knew for sure women were pregnant until after six weeks, when the enlarged uterus can be palpated), we now know that somewhere between 50 and 75% of pregnancies end in miscarriage. These aren't the heart wrenching miscarriages at 4 months in, but "oops my period was 5 hours late and so I peed on a stick, but it didn't stick" miscarriages. Now, for those who have been trying to conceive for months or years, and even some who haven't, these very early miscarriages can be traumatic. But they happen literally all the time. And that's presuming that the little bugger managed to develop enough to implant at all!

Miscarriages happen for all kinds of reasons. Genetics sounds cool, but the whole sexual reproduction, mixing of genes business is really a crap shoot. A lot more goes into building a new set of chromosomes than 23 bits from mommy and 23 bits from daddy. A few legs of daddy's may be garbage and mommy's may duplicate to fill in the gaps. There may be some random allele mutations. There's always a bit of crossover and assorted stirring. A G here a T there and you get a zygote that is shockingly different from its parents. Not like, crocodile to duck different, but different nonetheless. Sometimes, these random changes make fantastic things happen. Sometimes they result in a completely defective chromosome and development fails. The supposition is that most of these early miscarriages result from glaring chromosomal abnormalities, but such development-ending genetic issues aren't restricted to the first few weeks, or even the first trimester.

But, let's presume that we've gotten past this implantation phase and a mostly normal squishy thing is developing mostly appropriately. Now comes the issues of placental mammals. Our bodies are really pretty good at fending off invaders. We have an entire complex system of bits and cells and ooze dedicated to killing the nasty (little) stuff that wants to eat us. Our bodies are so good at this that sometimes the system breaks and our bodies eat themselves because they're so good at destroying things that look like invaders. Well, to prevent that from happening (most of the time), women's bodies suppress the immune system. Yes, that magical thing that keeps all the buggies at bay gets switched off. What a fantastic idea!! Add to that all kinds of hormones and weirdness and we have quite a mess. Then, don't forget, we now have a whole extra organ system developing that has to depemd on mommy's organ system working properly. If it doesn't, well, DOOM DOOM DOOM!

Sound terrifying? Ready to switch over to one of those happy, sparkly, trust your body blogs? Me too. But it simply isn't realistic. Even the ones that speak in evolutionary terms discuss how "fit" we are and how we have developed this ideal way to bear and suckle children... HORSESHIT. This kind of talk shows a fundamental misunderstanding of evolutionary processes and of natural selection. A great green forest sprite doesn't look at all the possible mutations and wave a wand at the super awesomest. Genetic mutations that don't function KILL THEIR OWNER. Everything else sticks around. Compound it with selective behaviors and anything that doesn't specifically repulse possible mates sticks around. Not a fan of moustaches on women, but you'll overlook it for those fantastic... tracts of land? The moustache persists. Fitness simply describes the ability to fill a niche in the ecosystem that keeps a species from going extinct.

Let me restate this simply, in big letters.

There are only two options.

Fit OR Extinct

If at some point a mutation occurred which guaranteed that a woman with the gene would bear heterogeneous fraternal twins, but that she would always die in childbirth, as long as the culture she lived in had a sufficient means to feed and raise those infants (wet nurses, improvised milks, commercial formula [gasp!]) to an age where they were able to then reproduce, the gene would persist. And we might have a whole society with twin babies and dead mommies. It would be horrible, from a humanitarian standpoint. But, as far as nature is concerned, it works perfectly well. Don't think it might happen? Well, probably not. But, remember that loads of insects and even some mammals die immediately after reproducing. And, for reptiles that abandon their clutches, the continued life of the parents is completely immaterial to the success of the offspring.

Nature is a bitch.

In our society, we have developed a means to prevent what would otherwise be natural deaths. Even cancer, given a genetic cause, is a perfectly natural way to die. Being eaten by bears? Natural. Splitting open and bleeding out while squeezing out a squishy thing? Natural. Getting a serious infection from an impacted wisdom tooth and dying of brain rot? Natural. But, when it comes to medical interventions, we have two options yet again. Embrace them or stick our heads in the sand and pretend that it can't happen to us. Now, does that mean I have to volunteer for every elective procedure under the sun? No. But it certainly means that attempting to ignore the risks (which are best dealt with one at a time in a bloggy environment) associated with simply being alive will only result in one thing. Death. Well, or dismemberment. That happens too. BUT DEATH FIRST!

Let's bring it round, back to fear and trauma, the actual topic of this post.

We have developed to the point where most humans have very happy, very long, very comfortable lives. (Except on such occasions where our own development gets in the way of that, like war and genocide and all those other fun bits.) The more comfortable we are, though, the more comfortable we expect to be. So we make up these fairy tales about how awesome the universe is since actually knowing how terrifying existence is makes us uncomfortable. We imagine that nature is kind and loving and that human beings are some supremely evolved, ideal machine that runs on kisses and sunshine and chocolates. We tell ourselves that taking Vitamin D will cure all mental illness and most of our physical illnesses too. We tell ourselves that birth is perfectly safe, and when it isn't is absurdly rare and the bad things wouldn't happen to people like us anyways. There are even those who have convinced themselves that nature gives a flying fig about how we feed our kids. And, of course, I have convinced myself that I can keep this last wisdom tooth.

Dante Hicks shat his pants because he didn't want to lift the lid of his potty. Momentum is a powerful thing, yo. And, in our lives, it sometimes seems easier to just "leave well-enough alone" and fail to seek the care that may in fact save our lives. It's big and it's scary and it's expensive and it's uncomfortable. And, damnit, the story just isn't as nice. But life is full of surprises, and most of them are quite unpleasant. We don't need to make matters worse by lying to ourselves.