Know We Kant.

He died of undiagnosed medical issues too.

He died of undiagnosed medical issues too.

The single most vital thing I learned at the neurologist this week was: I really need to read up on Immanuel Kant.  Apparently he made a pretty valiant stab at rescuing the concept of Free Will from science, but only by redefining science itself as an unreliable construct.  Or something. My neurologist is pursuing a PhD in philosophy. It made for some really interesting conversation in and around the needles he kept sticking into my muscles, and the little jolts of electricity he used to make them jump.  And the utterly unremarkable spikes and scribbles scrolling across the monitor.

Nothing to see here, he says. Judging by my reported symptoms and the way I winced when I pulled myself onto the examination table, he thinks it’s rheumatological. I pointed out that it was a rheumatologist who’d sent me to a neurologist. It was like being on the phone to Dell Tech Support.

He tells me that this is what I want, that the moment a doctor gives you a firm diagnosis then there’s definitely something wrong with you. I find this a surprisingly quantum-mechanical way of looking at it— it doesn’t exist until you measure it— but then again, the dude is pursuing a philosophy degree. And if any medical professional is going to find something wrong with you, you don’t want that person to be a neurologist.  Neuro is bad. Neuro always seems to mean wasting and spasms and paralysis and death. You never hear about people who come down with a fully understood, trivially-treatable neurological condition that can be cured with a couple of Advil. Nobody ever comes down with Singular Sclerosis.

This particular neurologist says it’s not unusual for weird suites of symptoms to manifest without ever leading to a definitive diagnosis. At the same time, he admits that my particular suite— the ability to run 10K without incident, coupled with fever and near paralysis when I walk the same distance— are “unusual”.  He has no explanation (although I myself am starting to wonder about a malign post-hypnotic suggestion somewhere along the line).

My strength seems to have largely returned at least, even if the pain and stiffness persist. My main fear is that some trivial bit of exertion— taking out the garbage, trying to hold more than three cats at once— might kick me past the Invisible Threshold and into another collapse. At which point, I guess I go to Emergency while all those acute symptoms are still on display, and tell them to figure it out.

Sometimes, apparently, this stuff just goes away on its own. If you’re lucky.  Whether I am depends on whether you put more stock in the fact that I survived Flesh-eating disease, or the fact that I came down with it in the first place.

Anyway. It’s not cancer, and it’s not Lyme (the blood work finally came back). It’s not arthritis or PMR or myositis or Giant-cell arteritus. And now it’s not neurological either (although I’ve got a card that gets me to the front of the line in case of another collapse). Who knows, maybe it’s gluten after all. Or maybe I’ve got some kind of weird new disease yet undiscovered by Science.  Maybe they’ll name it after me when I’m dead.

Just in case, I’ve prevailed upon The BUG to agree to the following terms: if it turns out that I do have something terminal and incurable, I get to stop working and just play video games in whatever time remains to me. It could be a slow, lingering death— it might take 40 or 50 years to kill me— but at least I can take comfort in the fact that my wife has agreed to let me pass with some semblance of dignity.

Speaking of which, a video game is what I’ll be writing about next time I sit down here. Enough of this open-ended, narratively-unsatisfying medical whingeing.  Next time I’m gonna review SOMA, only a year after it came out.

They say it was partly inspired by me.

This entry was written by Peter Watts , posted on Friday October 14 2016at 09:10 am , filed under misc . Bookmark the permalink . Post a comment below or leave a trackback: Trackback URL.

37 Responses to “Know We Kant.”

  1. Hey, maybe that’s the new career in your (very hopefully not) waning years – video game reviewer. Who knows, you could do for video games what Mr. Plinkett did for the Star Wars prequels. I know I’d like to hear you analyze the Deus Ex games.

  2. Just saw this article about another possible source of Lyme like symptoms, worth a look:

    https://www.statnews.com/2016/10/12/swiss-agent-lyme-disease-mystery/

  3. Dr Watts, It’s great to hear that if you’re not all better, at least you are not horribly worse. As I am not a doctor, feel free to ignore me if I suggest that perhaps it was an encounter with something new and unusual — or perhaps a previously unencountered zoonotic that couldn’t quite establish itself, but which was moderately and unpredictably horrid before it was soundly thrashed by a combination of your immune system and whatever obligatory nutritive aspect of which you are thankfully deficient.

    It’s probably a very good thing for your dignity that you live in Canada with a free healthcare system. Here in the States, as part of cost-saving efforts (for which read, profit-raising initiatives) a lot of formerly well-regarded hospital systems are losing their reputations as miracle workers. If something that isn’t fairly simply understood shows up, there maybe be a bit of referrals to specialists, but as soon as that’s done, if it’s outside of their own speedy diagnosis and cookie-cutter treatment recommendations, it all gets written off as “probably psychogenic”, meaning that insurance won’t cover it and no further action will be taken.

    Hopefully whatever disability you might have ongoing from this, won’t preclude writing and lecturing. Meanwhile, consider that anytime sincerely weird complaints cross their practices’ threshholds, most physicians will at least consider the possibility of involvement of factitious disorder. Now, before you get all irate at me, please remember that as rare as is Munchausen Syndrome, Munchausen-syndrome-by-Proxy is even more rare… but in the case of both, the likelihood rises in proportion with levels of intelligence, creativity, and scientific/medical knowledge. That being said, it supposedly takes extreme degrees of talent to come up with something that nobody has ever seen before and even more talent to continue to evade detection… and it’s a classic of such cases, also, that even when factitious disorder is suspected, suspicion settles on the wrong persons (or causes) at least as often as not. Clinical pictures become even more complicated if the patient is self-treating, even in an entirely reasonable and expected manner such as taking aspirin to reduce the fever of a common cold or as analgesic for headache etc. Thus should end my brief digression into the Kantian notions that science itself might be an unreliable construct, but a bit of sniping rearward would be to briefly remark on science as a construct being only as reliable as the fallibile humanity that informs science.

    Meanwhile… I wonder what sort of statistics might develop if someone were to query a large sample of SF writers to see how many may have had some kind of basically inexplicable medical condition. Maybe this would be best conducted by the sort of folks who write noir and horror and crime fiction… hopefully there is not a story to be found that they’d more instinctively spot than would the rationalists that write the best science fiction. In any case, “get well soon”.

  4. Well, I’m happy to hear it’s not neurological at least. Hope you get some better answers soon.

    If you do happen to go on a game kick, give Subnautica a whirl too. It’s a fairly immersive exploratory survival game with building elements set in an alien ocean, and it evokes a lot of Starfish memories for me. I built my own Beebe station next to a thermal vent, and had some fun going feral by snatching fish right out of the water and eating them raw. My favorite are the ones that look like giant floating eyeballs. Yum.

    Most of the time it’s a fairly low intensity, even soothing, experience with a lot of striking bio-lumiescent visuals, but the deeper you go the scarier it can get. When I’m in deep water away from natural light and I catch sight of something large and terrifying snaking around just underneath me, I experience fear on a purely mammalian level. In fact, I wanted to build an even more authentic Beebe station at the bottom of a giant chasm, but found that the environment was just to stressful for me there. I guess Im not “pre -adapted”.

    It’s more sandboxy and “make your own fun” than something like SOMA, but I thought you might get a kick out of it.

  5. I’m glad to see an update from you. Carry on.

  6. Have they tested for various parasites? Some parasitic infections can cause rheumatoid symptoms–Is there a role for parasites in the etiology of inflammatory rheumatism?

  7. “… trying to hold more than three cats at once…”

    If you are holding more than one at a time then you are not juggling them properly.

  8. Well, look at the upside: medical mysteries tend to end up in textbooks – you might be stumbling your way into academic immortality.

    More seriously, here’s hoping the improvement continues even if sans diagnosis.

    And as for SOMA . . . yeah. Definitely an influence. As far as games go it’s like if you and Richard Morgan hate fucked then left the resultant horror-spawn at the bottom of Challenger Deep for fun and profit.

  9. Peter, congratulations on not being _definitely_ dying real soon now.

    What’s your inclination? Do you want to push yourself and maybe trigger another attack so your doctors have better data to work with, or stay way the heck clear of exertion in the hopes the problem stays away?

    I’m guessing you’ve seen this comic:
    https://xkcd.com/242/

  10. Retired Kant scholar Robert Paul Wolff is currently using his spare time to make video lectures on the _Critique of Pure Reason_ in case you get tired of video games.

    His first lecture
    https://www.youtube.com/watch?v=d__In2PQS60

    His blog
    https://robertpaulwolff.blogspot.com/

  11. Maybe someone is sticking pins in a giant voodoo doll they made of you.

  12. You can run, but you can’t walk. That could be a clue. What systems are at higher functioning when running but not walking? Maybe adrenaline, O2 saturation, or digestive and pancreatic functions would shift.

  13. Though it is sounding like maybe some kind of allergic reaction, am wondering what a biologist turned hard sci-fi writer’s solution to malign hypnotic suggestions of unknown content is. Have spent some time thinking about this and usually boils down to guessing what it was and arguing oneself out of it.

    Congrats on no Lyme, etc.

  14. Here’s to Watts Syndrome, whose main symptom is playing video games to death. I’m only aware of one other case that occurred in South Korea.

  15. Could it be something as simple as certain movements of the body somehow putting stress on a nerve, probably high up the chain near the neck or something. I’ve heard people tell me they’ve had muscles in their forearms kind of lock up, but only temporary, and without much pain, just soreness. Sounds like you might be getting a much much more severe version of this.

    One thing I can think of that might help something, would be to meditate and just focus and try to figure out what your nerves are telling you. Total moonshot, but don’t think it can hurt (unless you sit in a weird pose and end up with a trip to the ER).

  16. Rather than “triggered by walking, but not by running”, seems more likely that there’s no Invisible Threshold; it’s something that isn’t triggered by exercise at all, either something that just happens intermittently/spontaneously without a trigger, or that can be triggered by something other than exercise. Hence my guess of spinal gout. Have they scanned your spine yet? It seems like the tests he did with electricity would rule out a systemic problem with your nerves, but not spinal compression caused by uric acid crystals accumulating on your vertebrae.

  17. So, has anyone suggested “it could be βehemoth” yet?

  18. Back in the day, when my career was utterly tanking––unlike now, when it’s only dispiritedly tanking, ha ha ha––I developed a horrible tic: every time I gave a lecture, at almost exactly 20 minutes in, I’d start getting black spots in my vision and very nearly faint. I never actually fainted, but I got pretty good at scheduling video clips for that point. And believe me, it was absolutely dreadful waiting for it to happen … and the dread, of course, made it sure that it did happen. And It passed the very day I was offered a job in a better university in a field that I was better suited for.

    My point is that while psychoanalysis and the like is platinum-grade bullshit, there is something to the idea that physical symptoms can mean something independently of physical pathology. And let’s be fair: a psychoanalyst wouldn’t have too much trouble making something of a condition that has you able to run before you can walk, if that means anything at all for you. (And yes, I know, it doesn’t.)

  19. The situation has its advantages: either you get better and have medical experiences under your belt (or in your bag of tricks) that you can use in your writing if you like, à la Cordwainer Smith, or you get to play lots of videogames. Not bad. You can also get better and keep playing videogames as you like. Go and take this one.

    You know you might have a strange luck, right? Some people seem to be like magnets for the unusual. Hopefully it keeps bringing you unusual good chances as well, from time to time. Also, a great deal of our luck we make it ourselves.

    Too many sententious phrases in a row, maybe. Probably a terrible way of cheering someone up. In any case, sincerely, all the best.

  20. When you have episodes of whatever this is, is reading too tiring to do? I don’t feel like adding to your inbox if that’s the case.

  21. While taking a moment to scour the internet for information that would unequivocally remove voodoo from consideration as a possible cause, I did come across a rather interesting and non-understood tick-borne illness called STARI, or “southern tick-associated rash illness”. The symptoms listed are pretty close to the laundry list reported by Peter Watts, with the exception that he didn’t report a rash, or at least was specific in saying that there wasn’t the rash typical of Lyme. I found that tidbit researching the Lone Star Tick in general, which Crawl readers will remember is associated also with an induced allergy to eating most mammals. Ticks, of course, transmit a lot of nasty weird illnesses. A layman’s article on the induced alpha-gal allergy adds this tidbit:

    It’s an interesting mechanism,” [Dr. Amesh] Adalja
    [infectious disease specialist at the University of Pittsburgh
    Medical Center] says. “It’s really the reverse of what we’re doing
    when we give allergy shots. When you get a tick bite, it
    primes the immune system by exposing the blood to this sugar —
    and that allows the allergy to develop.”

    Right now no one knows whether how long the allergy will last,
    [Dr. Robert] Valet [assistant professor of allergy and immunology
    at Vanderbilt University] says. “Anecdotally, there are
    some patients in whom it does resolve,” he adds. “The
    most important thing you can do if you develop the allergy,
    along with avoiding red meat, is to avoid more tick bites
    since the number of antibodies will rise if there are more tick bites.”

    I should mention that it’s not a terrible idea to go top-to-bottom now and then in any home, especially if you have pets. Your pets might be clean, but the prey that manages to get inside and be devoured may not be so clean.

    Well, off again to the task of eliminating voodoo from the suspect list… :)

  22. I have Ehler Danlos, a genetic disease with lots of invisible symptoms: Randomn neurological stuff happening from spasms to something like restless leg syndrom across the body, rheumatic pain and chronic fatigue (aka: “You should do more sports and stop being so lazy. It’s just in your head”). Most of the docs around where I’m living never heard about it so I just get checked off as “hypochondriac”. Long story short, I just want to give you some mammalian comfort by telling you that I commiserate with your story. I hope it either goes away or they find the cause.

    As for Soma: Can’t wait to hear about your opinion. I didn’t find it impressive as a game but the story was pretty good for a computer game. It never occured to me that you were an inspiration, since the story revolves around the central gimmick of mind copying which is something Richard K Morgan did in his novels. However, now that I think about it, your fingerprints are glaringly obvious, from the dismal underwater habs to the unsexy apocalypse right up to the diving suits.

  23. Peter,
    What is your diet like?
    There are few better places to look for triggers for physical reactions, especially now you’ve looked in your blood and in your brain and found nothing conclusive.
    You may think my focus on gluten, dairy, and caffeine is nonsense – I won’t try and argue otherwise – gather some evidence using a food diary and it may show that there is something else at play.
    ‘Let food be thy medicine and medicine be thy food’.
    “You are what you eat” is inescapably true at a basic physical level – the material your body is created from enters through your mouth.
    You went to Greece recently, for a couple of weeks, did you eat differently while you were there?
    If you ate ‘the mediterranean diet’ while you were there – lots of seafood, fresh vegetables, less red meat, wheat and dairy, then it’s possible that returning to that ‘western’ (hate that term, but for the sake of brevity) diet was the trigger.
    I’m sorry if I’m being a bore about this.
    I hope your suffering is alleviated soon.
    Tim.

  24. I wish you well on health. Platitudes like that are bullshit, but since nobody knows what the fuck it is I can’t really say more.
    I’m really excited to see your opinions on SOMA. I initially abandoned it because it wasn’t very scary (well, it’s existentially scary but the moment-to-moment, fight-flee-fuck lizard brain telling me to run stuff was very tame compared to Amnesia), but I picked it up again recently after reading Blindsight and a bit of Starfish.
    Having properly tempered my expectations, I really liked it even if [SPOILER] Simon was the dumbest sack of bricks on the entire ocean floor. I mean, I think that he’s got brain damage and all that, but some of the shit he says and refuses to understand is still absolutely absurd. “How big can an ocean be? Where did I get that flashlight? I want to talk to other humans, not human consciousnesses in an AI suit. What do you mean that I’m one too? I’m suddenly able to breathe underwater and function at the bottom of the fucking Atlantic ocean and have been transported a century into the future and have robot-looking hands, but I’m still human!”
    I do think that people give him too much shit about not getting that there’s no “coin toss,” since the website has an entire story about how an entire base of trained scientists don’t get it, (https://somagame.com/item-4520.html) but when it’s combined with everything else he says it’s still pretty fucking dumb.

  25. Shit, found a tweet confirming your influence five minutes after the edit timer went away.
    https://twitter.com/frictionalgames/status/638302799596548097

  26. Dane, I only played a few hours of the game, but you are right about Simon being extremely dim and not getting obvious implications. It isn’t as gut wrenching as Amnesia…also true. Plus the voice actor isn’t the greatest. But one sets that aside and it is a pretty cool game. I will see where it goes and hope for the best.

    To Peter, glad that it isn’t anything horrible, though still must be extremely frustrating that it can’t be pinned down.

  27. Hey Pete,

    Glad to hear you’re doing better! SOMA is one of my favorite games ever and I’m super interested to get your take on it.

  28. Actually, there plenty of neurologic conditions that are treatable or self limited, starting with…well, migraine. Or miastenia gravis (despite the name), many peripheral neuropaties, many intracranial tumors (not all are malignant) and others. It depends on what you have, not where it is. I’m glad for your results, just one thing: why has polimyalgia been ruled out? As far as I know it is a purely syndromic, clinical diagnosis, so it’s very hard to exclude it completely. IMHO that is still the most likely diagnosis. The first one put forward often is the right one….

  29. Happy to hear your strength’s returned. Hope the pain goes away.

    I assume the “too” at the end of the Kant caption refers to someone else… although if you’re writing from beyond the grave, cool!

    What I know of Kant’s work mostly comes from online comics, but my sense is that science is not so much unreliable (as a process it seems like democracy, better than the alternatives) as limited. If we have free will, it’s a form of godhood.

  30. I know the most about Kant due to http://existentialcomics.com/ :) and I am posting to make sure everyone knows about the comic.

  31. Lodore: My point is that while psychoanalysis and the like is platinum-grade bullshit, there is something to the idea that physical symptoms can mean something independently of physical pathology.

    I don’t know if anyone else has much made the observation that when we started appropriately treating neurochemical disorders with anti-depressants and neuroleptics and the like, we made stunning progress with psychoses but somehow the treatment of neuroses fell though the cracks.

    Honestly: look around us, folks, and tell me that there isn’t a huge percentage of our problems that need to be approached as if they were neurosis, and thus could be addressed only with cognitive therapy or simple rationalism based on analysis of situations and problems. I seem to recall some famous “shrink” saying something to the effect that the level of neurosis in any given group was effectively the average of the level of neurosis of all of the individuals in that group, and that it wasn’t a far leap to think that the level of neurosis of a society was the average of all of the groups neuroses. Strangely, the internet as an effective anti-neurosis group therapy session is working out less well than expected.

    While we see a lot of discussion here on this blog on the subject of neuro, a lot of that seems to be the nuts-and-bolts, well, wetware aspects. We don’t see too much discussion about software that drifts out of self-correction or functional adaptation, and goes past dysfunctional into malignant… but this case seems to me — and again, I-am-not-a-doctor — to almost certainly have some physical cause that nobody has quite yet found. Here’s hoping that either it fixes itself or that it can be resolved as to cause.

  32. Eaten anything unpasteurized, particularly somewhere foreign? They may have tested for it already, but chronic brucella family infections get *weird* and have a breathtaking array of intermittent potential symptoms. Ever noticed your sweat smelling weird, like wet hay?

    Brucellosis was really uncommon owing to, you know, pasteurization, but I’ve been expecting an uptick in it given the fad for unpasteurized farm-fresh hipster dairy produce. We were pasteurizing stuff for a reason…

  33. Gord Wait: Just saw this article about another possible source of Lyme like symptoms, worth a look:

    Yeah, a bunch of people have sent me this link…

    DA: give Subnautica a whirl too.

    I have not heard of this before. Engine must be pretty flexible if you can grab fish and eat them.

    Steve Halter: Have they tested for various parasites?

    Actually, they have not.

    Johan Larson: Do you want to push yourself and maybe trigger another attack so your doctors have better data to work with, or stay way the heck clear of exertion in the hopes the problem stays away?

    That first thing.

    Iron Horsecock:
    So, has anyone suggested “it could be βehemoth” yet?

    Daniel:

    Not this morning.
    You can run, but you can’t walk.That could be a clue.What systems are at higher functioning when running but not walking?Maybe adrenaline, O2 saturation, or digestive and pancreatic functions would shift.

    Hmmmm.

  34. Iron Horsecock:
    So, has anyone suggested “it could be βehemoth” yet?

    Not this morning.

    Lodore: there is something to the idea that physical symptoms can mean something independently of physical pathology

    Hope so. It would be great if I could make this go away by just adopting a positive attitude…

    Mr Noyes: Long story short, I just want to give you some mammalian comfort by telling you that I commiserate with your story. I hope it either goes away or they find the cause.

    Thank you. Me as well.

    Definitely not Tim: You went to Greece recently, for a couple of weeks, did you eat differently while you were there?

    Yeah, but this thing first manifested two weeks before I left Canada. The weird secondary relapse is what happened a while after I came back, but the underlying problem preceded Greece.

    angelo: I’m glad for your results, just one thing: why has polimyalgia been ruled out? As far as I know it is a purely syndromic, clinical diagnosis, so it’s very hard to exclude it completely.

    That’s my understanding as well. I think they ruled it out largely because the inflammation markers came back negative. But then all these other symptoms piled on for round two, and those don’t seem consistent with PMR either.

    Maybe it’s not one thing. Maybe it was some secondary malady sneaking in through a weakened immune system.

  35. Sorry to see you are not out the woods yet. Have you read ‘The Thing Itself’ yet? I think Roberts is disappointed in the reaction to his audacious and very clever, challenging book… remind you of anyone?

    Seriously, though, it’s cracking – and, of course, continues the dialogue with ‘The Thing’ you started so well, Mr W!

    I’d love to see you a review of it by you.

    Get well. Soon!

  36. When old people get together the major topic of conversation is their illnesses.

  37. My dad’s Parkinson’s involved being able to run but not walk. Angle worth asking about – and a somewhat encouraging one compared to a lot of neuro. Parkinson’s can be slowed a lot if caught early.

    Is Intelligent Design still in the pipeline? You haven’t mentioned genetically engineered squid in a while.