Digressions&Impressions

The Half Full Glass of Long Haul Covid

A big thing happened: I can read books again! I haven't tried philosophy yet, but I have started to read complex sci-fi novels. I finished Seth Dickinson's The Monster Baru Cormorant, which I had abandoned when I got sick, in thirty minute installments. Then, on Monday I started Arkady Martine's A Desolation Called Peace, which I read more or less normally without developing headache or fatigue. I say 'more or less' because I didn't read either with pen in hand and so without my more customary half an eye on a possible Digression. That is to say, despite many temptations,* I didn't have the intense interior dialogues with them I would ordinarily have. (Yes, I need to scribble in the margins of a book in order to have my best interior conversations!)+ But I was fully immersed in the narrative. 

So compared to my unfolding long haul baseline (here; here; here; here; here; here; here; here; here; and here) the glass is definitely half full. In addition some other non-trivial symptoms have been reduced in severity. I average now one lost day to headache per week. I even had a ten day stretch that made me hope it was completely gone, but that was premature. On average I sleep better; the proportion of good nights vs bad nights has become favorable. (The effects of melatonin are finally noticeable when I awake in the middle of the night; I now mostly fall back asleep.) And I am physically much more active. But this also brings me face to face with my body's real limitations now.

My son's day-camp was moved to a new location. It is 1,2 miles in each direction. The route there is down, the return is uphill. I do this twice a day. It's pure joy because I get to engage with my son as his dad again, and not just as somebody to avoid bothering. At no point am I out of breath or do my legs feel tired. But it does predictably generate the characteristic 'head fatigue' I have tried to describe before. It also creates the kind of fatigue I associate with the aftermath of day-long hikes, but without any endorphins or sense of achievement. So, in effect I still spend most of the day in bed (but instead of watching kung fu, I am reading again). The good news is that he goes back to school on Monday, and that is a third of the distance. 

In the previous paragraph I also hinted at another symptom that has not disappeared. I am still highly irritable in conversations with more than one person, and I get exhausted by phone conversations. So, dinners with my whole family are challenging. 

I have disliked most confident optimistic responses by people who tried to wish me well and encourage me. I know they came from a good place. But even so, I dislike being offered hope that is not sensitive to my particular circumstances (and ungrounded in solid evidence). For all I know the previous sentence might be a sign of clinical depression or resolute anti-religious aesthetic sensibility.  But the fact that I can read books again, and manifestly enjoy doing so, does inspire hope that I may recover some cognitive skills whose absence were grounds for quiet despair. Either way, in virtue of reading the solitude of my days has been alleviated because I have good company, again. 

 

 

Conversation is a Surprisingly Difficult Skill; the Covid Blues, part #28752

I wrote my most recent entry in my 'covid diaries' (here; here; here; here; here; here; here; here; and here) a week ago, just as a noticeable upswing occurred. Since, I am clearly capable of more physical activity -- I often clock an hour of intermittent walking each day now -- and I have a few 'clear' hours each day where I feel 'normal.' This despite the fact that my chronic insomnia is ongoing. I still can be struck by sudden head-fatigue out of the blue without any apparent trigger, but more often than not the head fatigue and occasional headache is a consequence of too much activity. I still sometimes awake to a headache (almost certainly partially responsible for the insomnia), but I now can be more confident it will dissipate during the day. 

The lecture course I was responsible for has ended; I now spend some of my good morning hours copy-editing proofs, which had been piling up, in twenty minute spurts and answering emails from the brilliant crew creating an index for one of my monographs. The department has been pretty good in leaving me alone during my officially sanctioned incapacity, but it is noticeable that beyond the many generous inquiries about my health, any business message I receive tends to be some bad news or an annoying issue that requires my relatively urgent attention.

Three days ago, during one of my insomniac mornings, I picked up Keynes's Essays on Persuasion. Despite his evident antisemitism, and the sense he is talking to a different audience than me, I read it with great deal of pleasure. I had forgotten what a wonderful stylist he is! And I was struck by how much he anticipates what came be to known as neo-liberalism, and how astute on the major political fault-lines around sexual identity of what we now call post-keynesian society (especially amazing because he never witnessed the keynesian version). (More about that some other time.) After an hour, as my family was awakening, I noticed with a quiet ecstasy that I had read him for a full hour without any headaches. Sadly, the feat has not been repeated since. 

One nice thing about my relative improvement -- not a moment too early, I have been bedridden for over three months now -- is that I have time to reflect on some of the symptoms that escaped my notice earlier. What follows was prompted by the aftermath of a nearly hour long phone conversation with a friend over the week-end. I had been needing some professional advice, so I made a phone-date with a trusted academic friend whom I have known forever. I felt in safe hands, and was grateful for his insight. There was not a single note of dissonance during the conversation and for most of it I just listened. (My wife later told me that it was noticeable that I said less and less as the conversation went on.)

I should mention that when I could, I had been avoiding zoom/phone conversations since a few weeks after I fell ill. But that was because of my extreme irritability to human voice and sensitivity to certain (not all) sounds that I had developed alongside my Covid. But while the irritability and pseudo-misophonia has not disappeared altogether, in my good hours it's no worse than normal. 

After we hung up. I was drained, and a pale green. I laid in bed for three hours uninterested even in a Jason Statham movie. I was also in a kind of shock. It had never occurred to me that listening to somebody and remain engaged with what they say, when you like them and they are talking about something you care about (Ceteris paribus), is work. (Yes jokesters, I am open to the suggestion I have never tried my hand at listening before!) 

Most of my cognitive incapacitation I interpret through the filter my GP handed me a few weeks (months?) ago, when she pointed out that anything that requires my brain to multi-task or split attention creates a kind of overload now. (As an aside, I have been bemused that both my GP and my occupational physician have deployed a set of metaphors -- 'energy'; 'force'; 'etc. -- to help me grasp my own situation that can only be described as new-agey.) And I have become rather disciplined in avoiding situations in which that is likely. So, even at home I avoid conversations or rooms with more than one other person. This is also why, on the whole, I am not watching complex drama's on Netflix, but action movies.

In 2006, when I first met Vernon Smith, I had the kind of interaction that in the hands of a better writer would be comedy gold. I had just landed my first tenure track position, and I was eager to talk about my paper in which I modestly criticized his methodological views, while Vernon's agenda was to learn from me about Adam Smith.   At some point during the conversation, I realized Vernon Smith (who had just won the Nobel in economics) was a very deep reader of Smith. (I warmly recommend Vernon's book with Bart Wilson.)* Since I had already learned quite a bit about Smith from Buchanan in the preceding years, and was then a respectful reader of Sen on Smith, this gave me the wholly false impression that economists as such cared about Smith. 

Anyway, during this conversation, he planted the idea in my head that Adam Smith might have been an Asperger. (Later I learned Vernon had shortly before revealed himself ('come out'?) as an Asperger.) Vernon's remark never guided my interpretation of Adam Smith (although it seems plausible hypothesis to me), but like many readers of (Adam) Smith I find his phenomenology of daily life astute, and I have been taught to see what he calls 'situations' or interactions in a new kind of light. As it happens, on my interpretation of Adam Smith, for Smith many of our interactions occur while we are simultaneously making rapid judgments ground in and about counterfactuals several layers deep about the agents' principally concerned (which might include ourselves). If this is confusing or too terse go read my book!

Now while I admire Adam Smith's description of social life, it is by definition not something you can quite introspect. (In some respects Smith's reliance on sub-conscious processing goes much further than Hume's.)+ So, I have always treated this part of Smith's moral psychology as an interpretation of his text not necessarily obvious truth. 

As I was reflecting on my total exhaustion after a kind and nurturing conversation, I wondered in silent amazement how much cognitive skill goes into a simple (low stress) conversation. And before I knew it I heard myself saying to myself that tacitly keeping track of all the boxes and, especially, diamonds during a conversation must be quite (ahh) energy intense. :)

Before hands-free calling opened the floodgates of people talking while walking on the street, the only people seen mumbling to oneself were the people you tried to avoid and the elderly (sometimes the same person). In fact, and I close on this, one side-effect of my covid is that I am starting to grasp some of the elements of what it's like to be elderly. 

For the first time in decades, I have no agenda each day; and I am incapable of doing anything quickly. (That still doesn't stop all the mishaps; while I didn't burn down the kitchen, last week I broke the microwave plate.) I also can't jump into any activity my son might tempt me with. His cheer, which ordinarily I would find lovely, now may in its exuberant expression may well discomfort me. And when, after reflecting on this and sundry matters,** I asked my wife whether I had aged these last few months, she said in the kindest possible way, 'I just had that thought last week;' she must have sensed the bullet pierce my heart before I registered it, so she quickly added for good measure, "but maybe with a haircut we can de-age you." 

 

 

Covid Noise and Norms

Looking back over my 'Covid Diaries' (recall here; here; here; here; here; here; here); and here), I realize they reflect a selection bias of my best moments. They can't really do full justice to my incapacitated stretches. What has remained constant is that on any given day, it's hard to say that I am really getting better: because I always remember a day or two or three ago crippled with headaches or the sudden onset of hours of what I have been calling 'upper head fatigue.' Even very good days (like today) are overshadowed by awful insomnia that has me normal tired throughout the day. 

Yesterday morning I awoke feeling great after a solid night's sleep. After a leisurely morning, the upper head fatigue set in just before Noon. I couldn't shake it off during the day; rest, fresh air, watching the Fast and the Furious (7), a banana-honey milkshake--none of it helped. By the late afternoon it caught up with me and I was very depressed. I seriously considered watching the battle of Helm's Deep to put myself to sleep--I imagined trying to explain to Seneca's ghost the equanimity that follows from watching uruks and orcs being slaughtered.

And even though I spent most days in bed, in a wider perspective I am clearly better than I was a month ago. And nearly every week I am capable of saying that. I often have a few clear hours each morning, and this week my strolls around the block are turning into modest walks down the hill. But even that depresses because when I go back up the hill, I am aware that I am carrying more weight than four months ago. 

Yesterday 'my lecture course' ended. Because I got sick so close to the start of the course, and because it's pretty difficult to find somebody on a week's notice to teach a course on the history of political theory in comparative fashion, my director of undergraduate education decided to replace my lecture course with recordings of my lectures by me of last year. (Nobody made morbid jokes around me about that dead Canadian professor whose recordings were used.) The course had more than five hundred students enrolled in it, and that's a big responsibility to hand anybody on short notice.

My wonderful political theory colleagues stepped up to do weekly Q&As (after having to watch my lectures, too), and I was assigned a student assistant and an instructor who coordinated the electronic interface with students and who helped create the exams. We switched to weekly multiple choice exams. Most of the questions were mined from my exams of the last few years, and the instructor created new questions. My main job was to sign off on the exams and answer student questions.

Once the course was up-and-running this set up turned out to work adequately. I would spent at most an hour a day on this (broken up in intervals of 15-20 minutes). The contact with the students was a life-line to the outside world, and cheered me up. The students were amazingly understanding and sweet toward me. I don't regret it. But in hindsight, it turned out I had to do a lot of work in January when I probably should not have. Even well organized courses have a lot of minor decisions to be made by the formal instructor: books were not delivered, copyright laws prevented us from sharing them online; understandably not everybody welcomed multiple choice formats. And I even spent time having to set up special zoom links for groups over 500.   

I suspect I was depressed yesterday because now I am alone with my illness and my anxieties without an activity that distracts me. When the brain fog lifts I try copy-editing proofs that have been piling up in short intervals. I am still not quite capable of concentrating on unfamiliar material, but when I read my proofs I am at least somewhat aware of what I am trying to say. A senior scholar, who after reading these covid diaries confided in me that she has had chronic fatigue syndrome most of her adult life, told me she works very fast in the good periods. Parents with infants also learn to do that.

Another scholar who read my covid diaries told me that some of my symptoms -- involving excessive irritability to certain kinds of noises (music, singing, eating of food, talking to more than one person) reminded him of his misophonia. I had never heard of it before, and so had to look it up. When I shared this on facebook, I discovered that more than a handful of my friends and professional philosophers suffer from it or have family that suffer from it. My scholar-friend who suffers from it cannot tolerate people eating in his vicinity. (He told me he is incable of lecturing if somebody is eating even a bag of crisps.)

Misophonia is a badly understood and awful syndrome; it must be hell on partners and family. Even during my worst periods of Covid, I don't have it all the time. It primarily accompanies the period of head-fatigue (which are also periods of incredible food craving). But it made me reflect on the start of my illness. 

In December I had a few periods of intense dizziness, which I have tried to compare to a rocking of the boat. I tried to combat it with rest, but insomnia kept me awake. Each time after a few days the dizziness eventually went away and I returned to my normal life. You may recall that because all my vitals were normal, my GP initially assumed that I was stressed. While I protested this at the time -- these dizzy spells also started after days of 'holiday' without any obligations --, I initially quietly wondered if she was right. Because I had been unusually irritable. (This is a tell-tale sign with me of anxiety and stress.) But I now wonder if I was already responding to the virus. 

I want to close with one more extended thought. I have been blessed by supportive family, and many well wishes from friends and academics; luckily my employer is all on-board with giving me time to rest and recover. Nearly everybody I interact with is familiar with tales about long haulers. And so I don't feel overlooked or ignored. (And as the above notes, I am incredibly lucky that my colleagues stepped up to do extra work.)

In my better moments I try to think about the politics of disability in a profession that tries to ignore it. And I have more admiration for and compassion to all our disabled colleagues who function at incredibly high cognitive level day in day out. 

I feel my experience casts some doubt on the 'naturalist' (even Quine-ean) assumption that our philosophical skills are a mere extension of our ordinary cognition not different in kind. In many respects I have regained ordinary cognitive skills, despite being philosophically incapacitated. (Yes, I know that this very paragraph involves a practical contradiction--but the philosophy I do here, I do kind of obliquely in my best moments glancing at what I can be in this format that because it is already my own acts as my cognitive scaffolding). Professional philosophy involves cognitive skills that are extremely rarified and requires the co-participation and co-constitution (Catarina is surely right about this) of our interlocuters.

But more important, because my disease has no natural state -- I can at present never rely on my 'normal' functioning to last the day --, I don't have (for lack of a better term) the self-trust that able-bodied and less-able bodied (learn) to have. Or, not to put too fine a point on what I am trying to say, even the disembodied Cartesian meditator has some trust in being able to continue in his way of being from one moment to the next (even if metaphysically he relies on God securing this). In my worst moments I can't trust my own inferential practices or even any practical skill. While I have not had near burning down the kitchen incidents anymore, the common accidents still continue--this morning I dropped the glass tray from the microwave.   

We are not really aware of such self-trust until we lose it, although I wouldn't be surprised if enactivists have tried to capture features of it. So, here I am, again, trying to convey what it's like to be aware of having a mind that's manifestly not itself, using a skill that is the long shadow of itself, while bumping up against the norms of thought that whisper 'exit here for madness'.

 

 

Covid Diaries Continued...

Last week I conveyed progress about my symptoms  (recall here; here; here; here; here; here; and last week). Inevitably (one of my two favorite jokes, Q: “Are you happy?” A: “Yes, I am happy, aber glücklich bin ich nicht…”),* that was followed by a horrid week-end of headaches. (To be sure the headaches are not as painful as six to eight weeks ago.) It was horrid because now accompanied by a weird nausea. 

So, while I was receiving all kinds of encouraging and optimistic well wishes, I was in no mood to project optimism. Luckily the headaches dissipated again and the start of this week (Monday-Wednesday) was pain free, mildly marred by the by now familiar fatigue (and accompanying hunger). Unfortunately, the last two days the headaches have returned. In both cases I awake in the middle of the night confused why I can't fall back to sleep, eventually I realize that I have a strange pain (which has moved, again, now to the back of my skull). But despite my insomnia, I did not want to skip this update.

As it happens, and perhaps not unrelated, I was shocked and deeply saddened by the news that Dr. Rachelle Dyanne “Dara” Bascara has passed away. (HT: her colleague Nick Cowen). I feel frustrated that my illness prevents me from writing a detailed appreciation now. Heidi Howkins Lockwood has a touching memorial on her facebook page, but I am not sure it is public.

Long before #MeToo was mainstream, Dara was one of the people who bravely broke the conspiracy of silence in the philosophy profession about the predatory culture of sexual harassments that was being tolerated. The shock at what she revealed, as well as the fact that some senior philosophers also criticized her for her actions, convinced me that the magnificent work of (recall) feministphilosophers crew had not yet ended this culture in our time. Her example and our correspondence going back to 2014 nudged me into a series of digressions that have remained among the most read (and friendship ending) pieces I published. Her example got me thinking anew about how to conceptualize the nature of philosophical integrity, the coherence between a philosophical life and thought (which I also digressed upon). 

 

When my family moved to London we got to know each other a bit in person. She was able to combine genuine activism, intellectual profundity, humor, perseverance in the face of much hardship and indifference, and more than a touch of glamour. She always made a point to attend my talks.

 

She was proud of her PhD thesis "Towards a Unified Theory of Oppression," at Birkbeck, and in our last quick chat she told me she was pleased to have a position at Lincoln. But since the Covid lockdowns our interactions had been much reduced. I always silently assumed Dara would have the last laugh. Dara and her family had already overcome shocking circumstances, including (if I recall correctly) a lengthy cover-up of a brutal police murder of her father.+ My sincere condolences to her loved ones, friends, and colleagues.

 

This week we had a Dutch election, and surprisingly my post from four years ago on the topic has held up exceedingly well (recall here). This time around the election campaign was even more focused on values. And foreign affairs barely figured into the campaign. The historic collapse of Social democracy and Christian democracy continued, but now all left-wing parties collapsed along with them. (In fairness, none run an impressive campaign.) Simultaneously, as a group the rise of neo-fascist parties continued, despite splintering and scandal, apace.

 

Democratic left and neo-fascist right (some of which clearly not paying even lip-service to minimal norms of democracy anymore) both have a fifth of the seats in parliament now. (That's not unprecedented: for most of the 1930s Holland was ruled by Colijn, who was not just a war criminal, imperialist and racist, but practically invented 'austerity'; see also this shocking episode on the fate of Chinese living in Holland). But oddly -- it was a year of pandemic mismanagement, unprecedented riots, long simmering exposés on institutional racism and perversion of the rule of law in so-called toeslagenaffaire (childcare benefits scandal) that reached all the way to the most important state actors and prompted a merely symbolic government collapse-- the ruling bourgeois quasi-liberal center (divided in a cosmopolitan and a more conservative branch) came out strengthened and will surely rule again.

 

Since I am a bourgeois liberal the result is probably the best I could hope for given the circumstances. One problem with Dutch multi-party representative democracy is that, despite its many virtues, it lacks good rituals for cleansing of the stalls. Even when a resignation is not just symbolic, the consequence is that many failed politicians get kicked upstairs (into quasi-judicial roles in the council of state) or are parked (as part of a spoils system) as mayors (in Holland these are appointed) and so can still influence people's lives in non-trivial ways. The effect is to give the appearance that nothing changes. My spleen about the election was lessened because my excellent direct departmental colleagues in "Challenges" were all over the media (including TV) as expert commentators.

 

I am always amused that Marx and Engels thought that Holland was a likely place to initiate socialist revolution. I now think that if the Nazis had allowed the Dutch government to continue as before after defeat in May 1940, De Geer would have been reelected. 

 

Hopefully, with Spring sunshine, next week my digression will be more upbeat.

 

 

 

 

 

 

 

 

 

 

 

 

 

Covid Blues, and Convalescence

During the last ten days there has been a noticeable improvement in the kinds and severity of symptoms: I slept well eight out of ten nights. (Interestingly enough, this coincided with a switch to a slightly lower dosage of melatonin.) Even in the two nights of relative insomnia, I did not suffer from the scary mental cycling in the void I had experienced before. There has also been no recurrence of dizziness. Since this was my initial symptom dating back to early December (recall here; here; here; here; here; and here) this is a great relief. During the last two weeks I lost about four days to incapacitating headaches (which are rarely in same place). But these headaches were less painful than I experienced in January and February (although -- and this was newish -- they were accompanied by weird nausea). Emotionally, they were not always easy because I find it very disappointing, even disorienting, to awake to a headache after a great night's sleep. In the greatest moment of all, on Tuesday I spent a few hours in the Spring Sun reading a science fiction novel (unaided by any devices). Because of that experience I feel that I have grounds for hope to recover most of my cognitive abilities. Bottom line, while I still spend a lot of time in bed, and reading is often exhausting, I am clearly suffering less in lots of ways than before.

The previous sentence also hints at the truth that I still suffer some symptoms. The two most pertinent ones are onset of fatigue/hunger and a general irritability, including noise sensitivity. I have tried to describe the fatigue before, but it now feels as if I had great deal of exercise a few hours ago (but without the accompanying happy hormones) even if I did nothing. This fatigue generates a hunger feeling. Initially, I assumed that my hunger was due to depression/boredom. And while I can't rule that out (since I surely have experienced both), the hunger accompanies the fatigue sensation like clockwork. Unsurprisingly, then, that I have steadily gained weight since I fell ill. (In very serious cases of Covid people tend to lose weight.) And while the fatigue regularly follows modest activity (short walks and reading on my kindle), it also seems to arise for no reason at all. Because it is now the main cause preventing 'normal' being-in-the-world, it is most noticeable to me. But it has been part of my covid from the start.

I have been relieved to learn that irritability is not an uncommon symptom in Covid long haulers. For, there is a kind of folk myth in our culture, I think, that experiencing vulnerability and the fragility of life, is somehow wisdom enhancing and personality improving. And while I certainly have more compassion for the incapacitated and, as I have hinted a few times, a better sense of how ableist many of the norms and structures of professional academic life are (and worth attacking--watch this space!), my self-image has taken a beating. Not, as one may expect, because I rediscovered that I really find too much joy in my work and reading more generally. I don't mind discovering I am more uni-dimensional than I have always strived to be. (Indulge me: using 'uni-dimensional' makes me feel like I am less cognitive impaired.) No, rather because I have been manifestly an impatient and often highly irritable patient. And while it's easy to point to how this is an effect of my inability to do even modest mental multitasking (which is true), it also points to larger distressing truth that my illness has amplified some of my worst character traits. (Yes, I write that despite reading John Doris on character before you did.)

There are still other signs of cognitive impairment. A few days ago, I managed to burn my left hand because I used the wrong cup in the microwave. And while this is the kind of thing that could have happened to me before Covid (I lose my keys and €50 notes regularly), it had never happened before.

Before I wrap up, I want to express my gratitude to all the kind notes, some brief some lengthy, of encouragement I have received. It is really very heartening. So, feel free to keep em coming! One subset of these letters is worth mentioning: a non-trivial percentage of the students in 'my' lecture course, who only 'know' me from watching last year's recorded lectures (that are being used to substitute for me) and my messages on canvas (and corresponding with me about the course), have sent wonderful touching letters. Often they confide their struggles with home learning relating it to how they imagine my experience (they know I have had covid--some even read these digressions). The students seems so much gentler this year.

One letter-writer -- you know who you are -- proposed a joint project on a historically and autobiographically informed pandemic bio-ethics that would get away from the management perspective that pervades medical ethics and would involve what Kant calls our duties to our animal self. This letter made me cry. (I won't try to analyze that now.) This friend allowed me to imagine a future version of me that could incorporate my long haul experience into an image of myself. I have already noted before the significance of my fellowship of long-haulers who in their sharing of their experience help me to cope with my own. But my response to this letter reminded me -- and this is part of my ongoing response to Callard (recall here; here; and here)  -- how important others are in shaping our aspirational selves. As all experienced teachers know (recall) the effects of our shaping our students are often indirect and surprising. Realizing that I can still be shaped like this, too, has helped me come to terms a bit with the gently closed doors because I had to withdraw from some wonderful opportunities and the sheer tedium of being able to do nothing and enjoy so little.

   

  

 

 

 

Covid, Humanitarian Experiment, and Reading (Oneself)

While day-to-day my life is characterized by a discouraging lack of improvement, in some important respects my health has improved significantly during the last two weeks: I am rarely dizzy anymore. Since this was my initial symptom dating back to early December (recall here; here; here; here; and here) this is a great relief. My headaches are mostly not incapacitating; out of the last nine days only Thursday and Saturday were really bad. (Strikingly, the felt location of the headache is still moving around my skull, and the timing of the headaches is without rhyme or reason.) My insomnia has lessened: melatonin aided, I now get about six hours of sleep even on bad nights. I also show more competence at basic life skills (like not nearly burning down the kitchen regularly). And I have longer periods (up to three hours) without any symptoms at all.

It's not all good news yet. Even extremely minor physical activity can create a very strange fatigue such that my head (from the nose up) feels very heavy as if filled with a heavy liquid. I call this upper-head fatigue, which makes me want to lay flat and close my eyes. Once upper-head fatigue starts I am basically out of commission for at least an hour or more. I emphasize this because it's not like my lungs or legs are tired after, say, half a mile of ambling. On a recent good day I tried reading a science fiction novel, and even after taking regular breaks after each page (!), within a short amount of time I had the same kind of upper-head fatigue. I return to this below because there is a puzzling phenomenon associated with it.

I also have very low tolerance for background noise, including things we would not be inclined to call 'noise' at all: e.g., simple conversation and music. If any of these things (conversation, music, noise) or other disturbances occur I can be quite irritable. I have developed something akin to the  hypersensitivity to sound that reminds me of what I have encountered in some autists. I also find conversation exhausting and annoying [I think this is very much out of character], and avoid it studiously (especially phone or zoom).* 

Above I noted that lots of minor noises are irritating; even so, I can spend hours watching kung fu movies, including the very violent Indonesian ones. My main 'research' finding of the pandemic is, in fact,  that the sub-text of all kung fu films is the corruption of state institutions generally due to money, but sometimes due to occupation or imperialism. Five Venoms - a cult classic -- exhibits this point relentlessly, also in the final shot. Some kind of reading is still quite out of reach. And writing remains a slow, painful exercise. Even so, I can spend hours reading stuff on social media without getting upper head fatigue.

This had me meditating on the contrast between skim reading (social media) and concentrated reading (books). I wondered whether when I am skim reading I am doing a lot of largely tacit guesses -- based on context and background knowledge -- about what's on the screen, skipping words even whole sentences while my eyes scan content. Whereas when I engage in concentrated reading of  books I am wholly present with the text often in silent dialogue with the material, switching intellectual or emotional perspective as needs must. Perhaps the latter really is a lot more taxing on neurons/brain/mind. 

My Dutch GP, who returned my call after-hours, listened to my symptoms and interpretation. She suggested an alternative, compatible interpretation: I am having trouble multi-tasking. And anything that distracts from my focus creates mental turmoil and disturbance/irritability. This sounded plausible to me, but I objected that when I read books I am hyper-focused. I was about to launch into a soliloquy on how I could close off from the world with my book in the noisiest public places, when I realized that she was explaining to me the difference between reading a book on the page and reading from a small screen. When you read a book, she said, 'you have to make out words and sentences and ignore enormous amount of other letters and spaces on the same page.'

I was suddenly completely present. 'Normally,' she continued, 'you don't even notice you're doing it. But now it's too many tasks at once.'

I have noted, including in some digressions, I suspect, that I have a growing conviction that even our smartest students with lots of cultural capital find engaging with books difficult. They are taught from text-books, which are good at providing ready-made information and puzzle-solving; don't read the Bible weekly, and are very used to being interrupted by social media which is simply much better at holding our attention (leaving aside that much social media is actively prompting our reactive attitudes). In addition, they are immersed in the pictorial and iconographic worlds of games. I have joked that, despite high literacy, in some respects our future will be more like the middle-ages when the taste for books was constitutive of a rarified niche. 

I asked my GP whether there were any experimental drugs she could proscribe, or whether she had any suggestions about how I could read a book again. After counseling patience, and reminding me to stick with not working, she suggested trying to use a ruler magnifier when reading a book, 'that way you can focus on one line at a time when reading.' 

When I mentioned all of this to my surgeon-cognitive-scientist spouse, she suggested a kindle might have the same positive effect. If she is right about this, I would give in and start reading fiction and philosophy on a screen and we would put a stop to my mad accumulation of books. As I turned to order a ruler magnifier online, I quietly added a waterproof kindle as well. I always laugh a bit when Thoreau presents his own life, in high minded fashion, as a humanitarian self-experiment. But here I am waiting for the courier eager to start my own experiment. 

On Covid Tedium and Regretting Oblomov

One of the strangest features of my slow Covid recovery (recall here; here; here; and here) is the pattern of (ahh) asymmetric cognitive impairment. I don't mean here just the loss of skill in doing things which I have associated with a kind of gappiness in my consciousness.

About two months in I am still incapable of reading books and spending more than thirty consecutive minutes on responding to emails. If I try to do do so I get a headache and/or a fatigue that feels like my scull is filled with a lead ball about two-thirds its size. The same effect is also produced by conversation, which I find very taxing, watching lectures, writing blog posts, and even relatively short walks. I still find most music unbearable even when well rested and without other symptoms. And when I am fatigued, even background humming or whistling can set off irritability and a kind of noise in my brain.

By contrast, I can spend my bedridden hours watching food shows and action flicks on Netflix; play online Scrabble; or scroll through Twitter and Facebook feeds. I am also aware enough of my situation to write emails withdrawing from commitments, and to spend my time reflecting on what I might do with my life, how to earn some income, if I never manage to recover the skill, that is capacity, to read and teach philosophy again.

I could, I suspect, write philosophy in short increments. But it couldn't be a professional or scholarly philosophy because I can't engage with other people's writings let alone the literature. In reflecting on this, I sometimes feel regret that my adopted philosophical style, even in these digressions, where I don't have to play by the rules of scholarship, is structured by the artifice of the imaginary, disciplined conversation with others; as distinct from, and opposed to, say, direct contact with concepts or arguments.

The other day I was watching The Grandmaster, a late and self-consciously more artistic and philosophical entry in the IP man series of kung fu films. In the key, climatic scene one of the protagonists (played by Zhang Ziyi), who has just compared her commitment to honoring the code of her family and her filial duty,  says, "To say there are no regrets in life is just to fool yourself." 

When you have spent more than seven weeks in bed, you have plenty of time to linger on one's life choices. So, perhaps that's why the just-quoted scene from The Grandmaster affected me greatly. I decided her stance is a fine response to the "I regret nothing" attitude of hedonism. (It is no surprise that Edith Piaf's song gets appropriated so often in commercials.) Of course, a life with only regrets may be no life at all! 

The existence and acknowledgment of regret is not a sunk cost fallacy, but rather a consequence of accepting or tracking the consequences of meaningful choices. The realization that one could meaningfully have, perhaps from a certain vantage point should have, done otherwise is a sign that one takes a certain kind of responsibility or ownership over one's actions.* It need not entail that one would do anything different. If one dislikes sentimentalism, one can call regret an aesthetic by-product of being accountable to self.

As I scan the books in my library, including the piles of books I had intended to read the past few months, I realize regretfully that despite my familiarity with its conceit, I never read Oblomov. I wonder if I had read it, I would have been better prepared for the in-activity, the Oblomovitis of covid long hauling.

As I was lying in the dark, the vacuous spinning of my insomnia wearing off, I decided that I regret I never read Oblomov would make a fine title of my aphoristic, covid memoires. 

 

 

 

Covid Limbo

Nearly 70,000 cases of covid infection were reported yesterday, 8th January. Of course that’s officially confirmed cases and the real number of infections will be much higher. A small but significant proportion of those people will go on to be hospitalised and a small but significant proportion of them will die in the next few days. As we are often reminded, as if to reassure us, most of these victims will be over 60 and/or have various ‘underlying medical conditions’, but there are at least a couple of important ways in which this narrative of reassurance is both troubling and misleading. First, this narrative, intentionally or not (and I think it often is intentional when seized upon by various covid deniers and ‘lockdown sceptics’) effectively relegates people over 60 and those with ‘underlying conditions’ (and the list of these conditions is much more extensive than people normally realise) to more or less sub-human status: those whose deaths and lives are apparently relatively unimportant. Secondly, the fact is that you just don’t know if you are ‘vulnerable’ or not to this virus – no one can be sure that they are ‘safe’ from it. Indeed it’s currently thought that one in 20 people who develop symptoms on infection might suffer symptoms lasting more than eight weeks and, further, a significant number of those people remain unwell for several months (at least) after infection. This isn’t ‘just’ elderly people or those with ‘pre-existing health conditions’, but includes relatively young, relatively fit and active people like me – I’m 45 and before I became very ill with long covid last summer I used to weight-train in a serious and focused way at least 3 to 4 times a week. There are many, many people in more or less the same position as me currently and, given the rates of infection at the moment, many more will find themselves in a similar place over the next few weeks and months. Those who think – selfishly and incorrectly – that the pandemic is of little concern to them personally really ought to think again.--Ed Rooksby, January 9, 2021 "Nine months in the long limbo of long covid." [HT Chris Brooke]

Last week, I was too depressed to pen a digression. This despite the fact that my very kind and supportive, university's occupational physician suggested that a diary in which I record my progress might be helpful. And there is progress to report: Saturday, nine days ago, was the last truly horrid day of intense headaches. Since, I have barely had any dizziness (the most recurring symptom), much more manageable bouts of insomnia, and much reduced spells of headaches. In addition, on several days I lacked the general sense of fatigue I have tried to describe before (recall here; here; here). In the post quoted at the top of my own, Rooksby, whose symptoms were considerably worse than my own, writes, "it felt like my brain was encased in cotton wool and that I was somehow removed from reality, like I was watching everything – including my own activity – from behind thick glass."  

Even so, even minor walks or an hour responding to emails can still induce a strange fatigue and irritability toward any kind of noise or disturbance (which helps me recognize the fatigue). And the depression was caused not just by my ongoing inability to read books, but also a sense that every sign of progress is quickly followed by a rude reminder that I am nowhere near recovered. Part of me wonders if the sense of despair isn't itself a by-product of covid given how many other weird (and mostly minor) intermittent neurological/cognitive symptoms I experience.

The university's occupational physician convinced me that I need to take my sick leave seriously. And so I have let go of most of my work related activities. As I decline requests to do tenure files, referee, blurb; postpone research activities related to a number of edited volumes and grants; postpone or cancel public lectures and interviews; withdraw from dissertation defenses; I accept intra-departmental political defeats, and I also register how much stuff I pack into my ordinary self days. 

Perhaps the depression was induced by the following uncanny experience. I watched myself lecture on video last week. The recording of the lecture series is used to substitute for my presence this semester. It's a huge lecture course (400-500 students). And while I am no Sandel, I enjoy and take pride in, allowing my lectures to be interrupted by Q&A throughout.  In watching myself -- and my ridiculously chaotic slides -- I realized that I was not so much explaining the material, but sharing what I found interesting or exciting and tried to explain the grounds of interest, while smuggling in concepts and arguments I am supposed to expose them to. I took a childish pleasure into watching myself lecture.

But my responses to student questions were different altogether. I suddenly realized, as I was watching the recording, that I often had no idea what I would answer then, or could answer now, and I would marvel at how my recorded self would quickly and sometimes humorously manage to process and incorporate the questions into the lecture. He could think much faster, much subtler than I can now!* 

When I mentioned this to the university's occupational physician, she laughed a bit. And said that I should not underestimate the skill with which I could handle complex thought when I was not incapacitated. I did not put quote marks around that because I don't recall the exact wording, but that's because she did use 'incapacitated' (in Dutch: arbeidsongeschikt). 

Rooksby (an accomplished blogger and writer), who I knew from a far distance, seems to have died yesterday (here). And that gives his words a special poignance. It's interesting to me that he has tracked the social implicature of 'underlying conditions' as sub-human-status. Back in the day (March 2020), I registered 'herd-immunity' as code for 'culling' or 'dispensable.' And I even satirized that our pseudo-Darwinian age would be followed by a religious revival that would refer to our era as the 'great culling.' When I feel a bit stronger, I want to collect my thoughts on being an incapacitated, philosopher. 

But I am lucky that I don't feel a stigma that I am incapacitated for work; and grateful for hard-earned victories of earlier generations, that I can draw a salary while being pampered at home by my very busy, hardworking spouse. I do find it frustrating and embarrassing that my already overworked and more junior colleagues have additional work because of my disease. The Dutch government has opened the purse-strings, but not for our underfunded universities. I know better, but can't shake the thought am letting down those that count on my help in their career/professional advancement.

Even so, I spent most of my days watching netflix and daydreaming about invited research leaves in lovely climes. With gradual recovery I am willing to hope that I will be able to read and teach again...although last week I could not quiet altogether my simmering panic I may not. When I was a teenager I saw a documentary about Willem de Kooning's late art, which was so much sparser than his exuberant and overflowing earlier work. Later I learned that he suffered from Alzheimer's. I wonder if my post-covid work will have such clean and elegiac quality.

 

 

 

On Covid Insomnia and Vulnerability

One of the oddest symptoms of my Covid is insomnia. What makes it especially odd is that I can't sleep even when I feel very fatigued.  This has, in fact, been one of the few constant symptoms during my illness (recall here). I don't have much trouble falling asleep at night unless I have a headache or extreme dizziness. But I often wake after four to six hours sleep (regardless of needing a pitstop or not), and then I cannot fall back asleep. It makes little difference whether I have taken a (mild) sedative or not.*

Now in my earlier posts (here), I tried to capture what it's like to experience the granularity of thinking that characterizes 'brain fog.' In contrast, during my insomnia, I feel like my brain speeds up, as if I am having manic episodes or experiencing the side effects of (recall) a prednisone treatment. But this mania does not inspire action; I don't feel the need to write (which I doubt I could). I just lay there, catatonically, yet ardently wishing to fall back asleep, my mind racing often prompted by an inchoate desire to understand my unusually vivid and action packed dreams and then moving on madly from topic to topic even though I really want to sleep.

There is one other feature that is odd about my insomnia. I do not actually have much memory of the content of these thoughts other than that they feel so rapid. It's as if the mind is spinning, trapped inside my lethargic body, but no traces are being registered in memory. 

When I initially contacted my GP, now more than a month ago, before it was clear I was suffering from Covid, I mentioned the insomnia to her and she thought I might be suffering from stress. I have had ample time to reflect on her suggestion. When I am stressed I do sleep badly. But often then my thoughts turn obsessively to the cause of my nerves or some conflict that, with little extra reflection, is clearly a way not to deal with the underlying sources of anxiety. My current insomnia is nothing, or almost never, like that. (I use 'almost never' because I have, as I have noted before, a low-level panic I may never be able to teach or read seriously again.) 

When I shared my insomnia with members of my covid 'fellowship'--other 'long haulers' within the profession that reached out to me quietly and that have been generous confidantes and sources of support--it sounded familiar to several of them. But a few also reported that the spinning mind was accompanied by their racing, even palpating heart. (That would scare me.)

The contrast between the blurry days of fatigue and dizziness, alternated with headaches, and the endless hours of sad, fast-paced noctural noths could, I imagine, descend into delirium. Luckily the presence of my family creates a sense of rhythm and structure by sharply marking night and day. 

A part of me would like to understand the bio-chemistry that creates such disjointed cognitive and neurological effects on me. One of the few books I managed to read during my illness was a novella, All Systems Red, which revolves around a robot, Murderbot, that senses it malfunctions and knows it has malfunctioned before. The mood of that bot, which when not called upon feats I can barely imagine doing while healthy, passes the day watching serials, is not far removed from my own.  

I wrote most of this post yesterday, which was one of the best days I have had since I was diagnosed with Covid. Compared to two weeks ago -- which was clearly the nadir -- things are looking up. This past week, I have had several day-time periods in which I did not have any noticeable symptoms at all despite the unceasing insomnia. It is difficult to feel genuinely optimistic because good periods are not enduring. Yesterday my intention had been to use the structure of this post for some reflections on the nature of disability and vulnerability within professional philosophy/academy. (Because I have been replaced within my lecture course with videos of last year's lectures, I had watched a video recording of myself lecturing.) But today is not one of the best days, so I won't go on and leave that for another time. 

Covid Fellowship and Constrained Living with Invisible Disability

After last week's digression on the effects of my Covid, I was very touched by the many generous well wishes I received. Reading notes of encouragement in my darkened bedroom filled my time for a few days. Thank you.

Two kinds of responses surprised me. First, while commiserating with me, a number of people shared publicly their experiences of living with regular vertigo, tinnitus, and headaches. They did so on this blog, but also in other social media. My piece was a trigger for them to come out, as it were, and share their otherwise invisible disability in our wider professional circle.* These testimonials give a glimpse of stoic perseverance and alert us, perhaps, to quiet suffering. 

Second, a smaller, but not insignificant number of covid 'long haulers,' and their partners, privately reached out to me, to wish me well, to encourage me, and also to tell me that they recognized my symptoms. They have provided me with fellowship and support through the chat functions of social media. 

Because I find speaking quite exhausting, I am, despite my family, rather isolated during the day. But the fellowship -- as I call them to myself --, has made me feel connected to those who have a sense of what it's like. Relative to the people who died or were incubated in hospitals, we don't seem especially stricken. But we struggle in a world designed for activity.

Because I mostly lacked the canonized covid symptoms  -- fever, cough, lack of smell, shortness of breath** --, the fellowship has been reassuring. Knowing that others, too, experience the waxing and waning of dizziness/boat-rocking, fatigue, headaches, difficulty concentrating, and insomnia has given me a sense it's part of the territory. They have given me a window, a sense of familiarity, into how my experiences hang together. 

Last week, I discussed my inability to read and focus; I have withdrawn from all professional activity. In particular, classes start without me next week. Even the fellowship can't remove the dread I may never teach again. 

This week, however, I want to give a sense of the manner in which the inability to concentrate ('brain fog') manifests itself in other ways, too. The most obvious example is that three times since quarantine ended, I nearly burned down our kitchen. Each time I skipped an otherwise obvious step; e.g., pouring water into the espresso machine after adding the beans, removing the paper-towel-role or the plate from the burning stove. Each time I missed that something was burning in front of my eyes until I smelled the problem, and, eventually, registered it as a warning.  

In reflecting on my experiences I receive, I imagine, an oblique glance at the what it's like of Alzheimers and dementia (and, perhaps, other forms of consciousness in animals and AI). And  there is no difference in experience. Compared to my pre-covid self my steam of consciousness does not feel more granular or gappy. I don't have a sense, in the moment, of my blind-spots.

Thanks to Dennett's work I am familiar with the fact that even very healthy conscioussness is full of unacknowledged gappiness. Because I recall my past capacity, I recognize, after the fact, that some of my behavior exhibits less skill-full functioning, an incompetence at tasks I had once been familiar with. Since I am nearly fifty that's not a wholly new experience.

A few years ago, the work of Elizabeth Barnes on disability taught me that the human condition should be conceived as constrained living (here); (here), (and here). The gappiness of my possible blind-spots is not experienced as constraint at all. I don't feel handicapped when I walk into our kitchenette.

By contrast, while I have some recollection issues (with names, especially), I have a pretty vivid sense of my capacities before Covid. And this alerts me to a whole range of new constraints day-to-day. For example, I have learned to walk while dizzy, which involves an inattention to the sense that I might fall any minute; instead I trust in the sturdiness of my legs.

I also can't listen to any music. In fact, the only distraction I tolerate is watching already familiar films, but not musicals, or TV  (or highly episodic series). This is also familiar to the fellowship. One curiosity is that watching explosives or gun-fights on Netflix does not bother me at all, but any other background noise -- the barking of a dog in the yard, even my son singing happily -- evokes the horror of a scratch on a blackboard.