before after

IMG_0015b1bPOSTCARD #200: CHIANG MAI, THAILAND: The phone alarm goes off. I was expecting it to do that because somehow it’s been part of the dream I’m having… that thing about the order of events happening – was it before or is it after? Sweeping long-arm reach around in search of the alarm, slide it off with fingertip over glass screen and it seems like so much has happened since… who what where when how? My phone’s blinding white light in the silence fades and everything goes black again… the time is 5.30 am.

Something that’s new in my life these days is every morning, noon and night, I have to check the contents of two small carrier bags full of vitamin pills, pain pills and other pills contained in bottles, small, medium, large, with labels which tell me if it’s a ‘before’ or an ‘after’ – one of three events: breakfast, lunch or dinner. It’s the kind of thing that gives you a headache but enough said about that. I have to be up early enough to take the before-breakfast meds before breakfast and I’ve forgotten… my niece M stumbles into the room in a daze. I have to see if there’s anything she needs or wants and realize oh no, the ‘before’ meds so they have to be included in the ‘after’ meds. Okay, double-check, is it ‘after’ already, or is this still ‘before’? Something in me fights rationality with a reasoning that begins somewhere after the event and travels back to where things were around the time it started, just to see if that fits okay with how we’re now forming an idea of what this is about.

I have to get to grips with these medication bottles, fumbling with childproof caps in the alarming nearness of ‘seniority’… my goodness, is this a test! Select each capsule and put it on a small dish on the table. There they are, visitors from another universe. Then, swallow, swallow and swallow. Gulp and swallow again and stop to think, where are we now… did I take this pill already or have I yet to do that? If I’ve managed to do all this correctly then the rest of the day is easy. My niece M stumbles into the room in a daze and I have to see if there’s anything she needs or wants and it’s a good thing I didn’t forget about the before-meds.

There’s a dream I had once and wrote it down on a scrap of paper as soon as I woke up. The paper has been lying around for a few years, all scruffy and folded. Hard-to-read scribble so I better get it in print before it’s faded away in time. It goes like this: I’m standing at a bus stop, waiting for the bus. It comes, and I get on. Instead of ordinary bus seats, there’s furniture, sofas, armchairs, a small coffee table, TV, curtains on the windows, and it’s laid out like a room interior. I find a place and sit down. Other passengers on the bus are sitting up properly in unmatched furniture, everybody looking around for the person who comes to get orders for snacks and drinks. Nobody comes, there’s a long interval of nothing happening at all and after a while I realize it must be because the bus hasn’t left the stop yet.

At the same moment I remember I left my shoes outside the door at the bus stop. This is because in all houses in Asia you have to leave your shoes outside when you enter. Yes, but something about this worries me – is there enough time for me to go fetch my shoes in from the doorway before the bus leaves? I feel my body trapped by something unknown, unable to move… ok, I’ll just leave the shoes there and when I get off the bus I’ll have to take someone else’s (it does happen).

But there’s something not right about this idea. I’m searching and searching, so much and with such intensity it’s extraordinary and I become convinced that I must have forgotten what it is I’m searching for. This could be a problem but I’ve convinced myself I’ll be able to recognize what is when it appears… how will I be able to know what it is then if I don’t know what it is now… hmm? Well, we have not reached that point in time yet, so let’s see. Everything’s in a shambles and disarray inside this bus, chairs and sofas all facing slightly in the wrong way. Why is it like this? Must be the constant movement of the bus going along, furniture gets shifted around – we swerve round a couple of sharp corners, and everything slithers off to the side again…

Intuition is a suspension of logic due to impatience. [Rita Mae Brown]


21 thoughts on “before after

  1. You need one of those medication sorters. I have mine sorted with pills daily. I just have to remember which ones I take at what time. Interesting dream. Maybe you don’t want to leave the comfort of home.

    • I’ve asked about them, different types but couldn’t understand the sales staff’s explanation of how to set it up… I’ll get around to it, will have to.

      • There are some that you set up 7 days with 3 or 4 section for your daily dosages. They have some you can sort your medication for a month. I use one to sort my meds for 7 days. I put all the meds I take each day. Say on Tuesday I take all the pills and put it in a pill box. I know my pills and I take at the time I’m suppose to.

      • Thanks for this, the first sensible explanation I’ve had about the system. I live in a place of almost no English but worse than that is people earnestly explaining things from the end to the beginning and you have to sort it out the right way round – welcome to my world…

  2. Torn between the desire for the ordinary comfort and security that home brings and the journey you must take in your Pain state to get form here to there? Shoes left behind at the bus stop representing the fear of forgetting to take the right pills in the right order perhaps? Or perhaps not.

    Who knows. They say dreams are a doorway to our subconscious. They also say dreams represent our desire to escape reality. They may arise after trauma (death of a loved one, earthquake, accident, surgery, fear of commitment) – just about anything that’s praying on our mind may be reflected in a dream.

    Life with chronic illness (and pain) becomes a regimented routine and many of us lose the ability to do anything much outside this routine. We may dream of other realities or lifestyles, but are restricted to the daily grind of medicines (taken at the right time), supplements (taken before or after food), exercises (in my case particularly), household chores (done daily so they don’t get to an insurmountable pile in my case) and most importantly, minimal activities in order to avoid exacerbation of symptoms and/or pain.

    It’s called Pacing. Not too little. Not too much. Rest when needed (or meditation for you perhaps, Tiramit).

    It’s also called Reality.

    No matter how many times you wish you could just ‘get on the bus’ to go somewhere else, you fear leaving home without your comforts (furniture) and support systems (shoes). If you do go elsewhere, your comfort zone disappears in a jumble of difficult to navigate surroundings (unmatched furniture). In those new surroundings you fear there will be no one to help you (with essentials like food).

    But perhaps you fear Fear. You fear that this pain state will never end. You are becoming so worried about the possibilities becoming probabilities.

    Stop worrying about tomorrow and just deal with today.
    Tomorrow is not important as it’s not here yet. No point thinking about yesterday either. It’s gone. Nothing can change yesterday.

    I wonder if you’re becoming too anxious or developing an anxiety state that is beyond what would be reasonable for your situation. (just trying to suggest possibilities here).

    And yes, my pills are lined up too. I keep them in a small basket (supplements) and my prescription meds (in a small zip bag for ease if I have to take them elsewhere).

    If the basket and bag are on the kitchen counter, I know I haven’t taken them. If they’re put away on the front shelf of the cupboard, I know I have (taken them).

    In my shoulder bag I have a typed list of all my personal details and emergency contacts, my allergies, a simple summary of my health (with the most important item being at the top of the list), my pension/hospital patient numbers (of the 4 main hospitals I’ve used and still use) and my different specialists (or neurosurgeon in case of a severe fall) and their contact details. Every time I go to a new Doctor, Specialist or Hospital E.R. dept, I don’t have to remember the most important details. That list is invaluable, especially when I had the symptoms of a heart attack in 2010 and was too distressed to answer the ambulance attendants questions. This list is my support system. It tells anyone how to help me (in the face of my not being able to ask for help myself).

    I have disposed of my worst anxieties to a list. 3 pieces of paper. I have transferred my internal Fear to a piece of paper so that my Mind can get on with the practice of Mindfulness.

    Are you keeping a daily journal or diary? Try transferring all you anxieties to it. The Diary can be your Fear Repository.

    • Hi Vicki, am I keeping a daily journal? Yes, notebooks everywhere and scraps of paper with scribbled notes which are refined, broken down, rephrased and from those emerge the posts for the blog. So much imagery here and 30 years of it. I really don’t do anything else nowadays except this remedial analysis of anxieties. The blog is a readable journal, reduced as far as possible to minimalist state. Everything else that goes into the preparation of it, all the frantic scribbles etc., become the ‘Fear Repository’ for a while but usually get scrapped after they’ve served that purpose.
      And there’s quite a bit of fear and dread in Delhi, confrontations with the Walking Dead that come and tap on the window of the car demanding money, when you’re stopped at the red light. It doesn’t help to know there are no free-lance beggars, all are part of a syndicate, organised in an Oliver Twist like form except these comprise the lowest in society. Individuals with ugly deformities are the better off, you notice they’re slightly plump whereas the ‘ordinary’ beggars are really very thin. A few children run around in the cars with bunches of flowers. They belong to street-dwelling families, second generation rural/urban migrants, really tough little human beings. These are the only ones you see close up, but it could be that 80% of the population live in circumstances we would normally find hard to believe.
      The dream about the bus must have been when I first came to Bangkok from India in 1984 and in those days it was much more of a shambles and survivalist urban environment than it is today. For me it was a step up from my 2 years alone in India working for the NGOs in a quieter, semi rural situation. I didn’t have the experience of getting around in an Asian city, getting on a bus, the only white guy, and trying to find something like an address in a pretty bizarre setup, no English at all in a city of unfamiliar food, toilet signage written in Thai with no symbols. All kinds of understandably fearful circumstances but forgotten now; those were the youthful days when we’d find the necessary enthusiasm.
      You’re right about being ‘torn between the desire for the ordinary comfort and security that home brings and the journey I must take in my Pain state to get from here to there. Also the images of distress, anxiety and coping with it. I carry my passport with me or an ID card I have that has all my details, but there are no white people in my circles, hospitals and clinics are frighteningly dirty in Delhi, but I haven’t gone down with any infection as a result, so it’s a thing of the mind. I’m resistant to these levels of hygiene (lack of), could be that Western folks live in a level of sterility that’s uncommon in world populations.
      I carry a reasonable chunk of cash even on the smallest errand, in case of emergencies. Nothing can be relied upon as we know it in the west. In the streets the traffic comes first, pedestrians usually have to have sufficient mobility to run across the street or try to find everything that’s needed in one block without crossing. Not easy and these days I’m more reclusive than I was. Live in gated communities, have someone drive me from A to B, in Chiang Mai travelling by Tuktuk and taxi is quite pleasant. People are not confrontational. I like it here.
      Have to stop now, it’s getting too long. When Jiab retires we will stop travelling and stay here. Thanks for your observations Vicki, we do seem to live different lives. Now I’m disabled in the mind mostly because of the head pain that’s with me all the time, still learning how to manage medications.

      • You sound as if you cope with the different living conditions very well, Tiramit. I doubt I would in the same situation nowadays. I’ve had too many serious health scares, particularly heart and BP related to cope in a non-western environment now. When I was younger it was different. I just had a quick look at my few Thai photos trying to remember whether I went to Chiang Mai in 1975 or not. No location names on the back of my rather feeble & faded images. I remember my friend (who lived in Thailand for 3 yrs) talking about going up to Chiang Mai with an ex-pat charity fund-raising committee so she could enlighten me on what it is like in more recent times.
        My Fibromyalgia and Chronic Fatigue Syndrome leave me with intermittent cognitive dysfunction so can, perhaps, understand where you’re coming from. I keep my life very, very simple and try not to multi-task or arrange early morning appointments or errands which helps. I daresay you are learning to do the same. When you work out a routine for managing your meds, you will feel much less anxious. You are lucky to have Jiab to help you, even more so when she retires. One can only hope the pain has gone one day, so that you can both enjoy retirement doing more things together. I’ve never been to India, but my brother (on a business trip) said he was shocked at the abysmal state of the beggars. Bangkok was very rural and one story buildings when I was there in 1975. When my friend and her family lived there many years later, she said there were some 55 shopping malls and they lived in a penthouse at the top of a 30 storey bldg. Times sure do change.

      • Yes, I remember when Bangkok was something resembling a rural hick town with pretty bizarre foreign residents and the places they’d hang out in. Nowadays it’s like any world class town (on the surface) and Thais are more used to seeing foreigners visit of course. The same with Hong Kong, Singapore, KL and Penang. Asian cities have transformed in the time I’ve been here. They aren’t limited by Building regulations in the same way we are in the West and mostly it’s an adhoc situation; solutions are found to problems that may in fact be surprisingly creative, but unexpected if you come from a place where there is uniformity mostly in the structure of the urban environment.

        Sorry to hear about your Fibromyalgia and Chronic Fatigue Syndrome, I had a friend suffering form this, people just don’t understand about these conditions. I notice the same kind of thing when I describe how it is to have PHN in the head. But I don’t have the situation of serious health scares that you have, except for one heart/chest pain and seizures. I don’t have an acute BP situation. The difficulties I have are related to the space I live in; having chronic pain in the context of the hazards of functioning in these non-standardization of the home and urban environment. Ergonomics is a concept that just doesn’t apply here. Things we just take for granted in the West don’t exist and I suppose that’s the advantage Eastern urban dwellers have over us in the West; they have developed an awareness of the unexpected, mindfulness about accidents and simply the dangers in interacting with the environment. By comparison we Western folks are like babies, falling flat on our faces all the time and getting into all sorts of difficulties because we expect things to be standard and they aren’t.

        And here I have to say that actually I’m not good at coping with these ‘different living conditions’. A characteristic of the PHN headache problem is irritation and frustration if things don’t move along as expected, as well as loud noises and high pitched sounds in construction sites that continue regardless of danger to the hearing. Ordinary things like non-standardization of table heights; slightly too low and you bang your knee when you sit down, and chair heights sometimes too low and causes backache. The height of steps up or down may vary, one time in Japan I tripped on an unseen step of about 1 inch leading up a metal staircase and cracked a rib. The height of banister rail are all different, all kinds of variations, no building regulation codes about standard heights. Doorway heights are a problem for me, slightly too low so I’ll seriously injure my head. I feel my head at the crown and there are these old bumps like small mountains.

        No regulations about the pavements, height of steps up/down and of course walking itself is difficult due to multiple obstructions. In Delhi most women pedestrians choose to walk on the road rather than the pavement because of men urinating everywhere like dogs. For me, walking around the busy market areas or shopping as one might do in the West is not something I choose to do, unless I’m in it for the spectacle aspect. Just to quickly get a few things without planning for it, isn’t possible due to multiple issues. So I’ll go somewhere that’s known to be okay and go by car usually and generally minimize contact with the outer environment. These days now I have the headache to cope with, the best thing is to remain indoors and I have a large roof terrace, sometimes walk in the park maybe early in the morning.

        In Thailand I find Chiang Mai is really very pleasant. The best in Asia, although there are the same hazards in the urban environment. It will have developed hugely since 1975 if you were to see it now. Thanks Vicki for your comments and I’m sorry if this sounds a bit over the top but it’s how it is. I find it difficult to write about living in Asia because it sounds too strange and people don’t like to read about that sort of thing. Thanks for giving me a chance to try to get this uncomfortable subject into an acceptable form…

      • I welcome all the information you write about, Tirimit. Firstly, I have a long interest in health – Mind, Body, Spirit…and alternative therapies, especially Eastern.
        Secondly, while I can’t travel (health/money) nowadays, I’m always interested in hearing about lifestyles and environmental issues. I was truly fascinated in the information about building/living standards (or lack thereof) in Asia, as the smallest variation in chair height, desk, path etc affects my pain levels. If I can manage to pace myself correctly….movement, rest, right diet, hydration, air temp etc. I have a surprisingly good life. I’m always interested in how other people manage their chronic pain too. So the time you labour over writing on your blog is very meaningful. Unlike most people, I find it good to share my thoughts. Sometimes writing them down and a response from a stranger can put things in perspective and it pays to ‘get it of your chest’. To me, it’s not about being negative, it’s about being realistic and honest. Life isn’t black and white. It has varying shades in between. Life has tone and texture. Same with emotions. Even the Dalai Lama, a man renown for his compassion and humour, admits to being a little (maybe a lot 🙂 ) angry at times.

  3. I liked your dream Tiramit. When I read it a second time I imagined it was moving the whole time, even though it seemed it was not. Like you get on the bus, the door closes, and the inside of the bus is moving along– you can’t tell other than the furniture sliding around, but it’s moving. You get back off the bus and look at the outside of it, and it hasn’t moved an inch. How could it be that the inside and the outside of the bus seem to have their own rules? And how do we join these two worlds together meaningfully? It struck me as an interesting question– like joining the inner world of our meditation with going grocery shopping, or organizing your meds. How do we join them together meaningfully?

    Hope all is well, my friend. You’ll know it when you find it I think. But don’t ask me what it looks like if you get off the bus at that stop! 🙂


    • Thanks Michael
      Yes, the dream and the world. It was interesting for me to revisit it in the writing of this post, and see how much of it makes sense in logical way although it’s obviously a dream. I think your extentions to it are wonderful! The inner and the outer, a perfect example of our understanding of duality/nonduality. Your observations point to actually how it is for passengers on a bus or public transport vehicle. It’s more noticeable like this than being in a private car because we are more likely to be caught up in the act of driving or engaged in some inner process. In a silent group of seated individuals it becomes really quite obvious, but we are all separated from each other or we separate ourselves from each other. If you went up and down the aisle and called out joyfully to everyone: ‘Can you see it?’ you’d be escorted off at the next stop. So it has to remain as an individual’s view of duality/nonduality but when was it ever not? There’s a familiarity about this, a sense of something remembered that was forgotten but still not available at this time. I have to conclude that I don’t actually know what it is but l’ll know it when I find it, I think…

  4. Sorry to be so late in seeing this… Although I am subscribed to your posts they never come to my inbox so I checked and found three news ones… On my way to the doctor myself. Hate this waiting and a new doctor. Your experience in South Asia sounds a lot like mine in New York City for reasons too complicated and convoluted to go into. Have to get ready to go out of the apartment in a few minutes, a major challenge in itself! But, yes, you must get a medication sorter. I have 7 days with four compartments each. Otherwise chaos. Hard enough even with this to keep track. Maybe I can read your other posts in the doctor’s office. Or later. Courage, my friend.

  5. Pingback: contained spaces | dhamma footsteps

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