2023. Annus horribilis and a Gift.

Jimi Hendrix playing Room Full of Mirrors

At least by some measures, New Years are supposed to be periods of introspection.  If so, the annual arrival of New Year’s this year certainly has been for me.

2023, by which I really mean the period from October 2022 to the present, has been the worst year of my life, and that’s saying something.

Probably only people who know me really well would know that I’ve had, at least by western world standards, a rough life to some degree.  My teenage years and early (20s) adulthood was overshadowed by the physical and accompanying mental decline of my mother, something that still hangs over me like a dark cloud in a lot of ways.  It certainly sprung me from being a child at age 12 to an adult at age 13 virtually overnight, and not in ways that were good really, but in ways you can’t ever get back.  My relationship with my mother really didn’t recover in some ways until she was near death, and it never recovered in some ways.  I’m still working on that, trying to understand that what happened to her wasn’t her fault, or anyone else’s.

Added to that, the death of my father at age 62 was an irreparable loss to me that I’ve also never recovered from and won’t be able to.  As I noted here the other day, being an only child meant that I didn’t have a sibling to help endure this loss with, and when he died the person then closest to me in the world died, leaving me with an obligation to my mother that was a very heavy burden under the circumstances.

In short, things haven’t been always a treat.

But then, are they for anyone?

It may in fact be the case that everyone’s life is rough, to at least varying extents.  Maybe its best if you don’t even recognize that fact.

Anyhow, in October, 2022, as I’ve noted here before, I had colon surgery, following a colonoscopy that revealed a polyp too big to be removed in that process.  I really waited well beyond the age at which you should have your first colonoscopy, which was inexcusable on my part.  Had I gone in earlier (a lesson for everyone who might read this), the surgery would never have been necessary.  Ultimately the polyp proved to be precancerous, and was “as close to cancer as it can be without being cancer”.

I was 59 years old when I went in for that and that’s the very first instance of surgery, other than I suppose oral surgery to have a broken molar and the nearby wisdom tooth, taken out.  What I didn’t really grasp, but should have even due to the oral surgery, is that I wasn’t going to bounce back right away.  I expected to.  I didn’t even really expect to be out of work for more than a couple of days, in spite of everything that everyone told me.

Well, I’ve never fully recovered from the surgery and I’m not going to, that’s clear by now.  I notice it mostly in the mornings.  I just can’t eat.  Things make me sick, no matter what they are, as a rule.  The onset of late in life lactose intolerance has made that even worse.  For decades what I ate for breakfast was cereal with milk.  I can’t really eat that anymore.

So be it, but what really surprised me was the onset of really deep fatigue.  I was simply worn out from the surgery and it lingered for months.  I was tired like I never had been before in my life.

To compound it, when the diagnostic films were done for the colon surgery, a MRI was done all the way up to my neck which revealed I had a sizable polyp on my thyroid. The same surgeon recommended that the thyroid come out and seemed to look at the question as to what to do as almost absurd.  I was so surprised, and so beat up from the first surgery, that I went to my regular doctor for a second opinion.  He referred me to an endocrinologist. That doctor had no qualms at all about what needed to be done.  It needed out, the risk of cancer was so high, I was informed, that it was almost certainly cancer.

Great.

I ended up having a partial thyroidectomy in Denver.  I was extremely hesitant about the whole thing.

Well, the polyp turned out to be benign, which overjoyed the medicos but made me feel like I'd done something I could have avoided. After surgery, I hoped to avoid medication (I've never had daily medications), but wasn't lucky there either.

Since the thyroid surgery, and particularly at first, on a lot of days I've just been in a fog and tired all the time. It’s a difficult thing to describe, as it’s a feeling that’s internal.  I don’t think anyone else noticed it at all, but plowing through my days, and that’s what it felt like, I just didn't feel right.  I complained a lot about it to my wife, but in retrospect now I realize that if you complain a lot about certain topics, it become routine and won’t be paid too much attention to, particularly if there are no external manifestations that are obvious.

There were in fact external manifestations, but they weren’t obvious to anyone but me.  Normally, I look forward to the weekends and feel disappointed if I have to work on Saturdays, which I often must do.  I was so tired and dragged down, however, that I actually started to look forward to having to be in my office on Saturday.  I’d drag myself out, a little, to go fishing and hunting, but my feet felt leaden and I just wasn’t having the fun I normally did, the exception being when my kids were here.

I just went in for a follow-up and upon examination just recently. At that time the doctor asked me how I was doing and I reported what I was feeling and experiencing.  He gave me a physical examination.  I didn’t have bloodwork yet, as doing this on December 26 meant that I didn’t have the chance to get it done.  Based on the physical examination, they determined they needed to up my meds. “Everything will be fine”, I was told.

The bloodwork came back and showed everything to be just what it should be.  They immediately cancelled the doubling of the meds.

Long story short, what’s going on is post-surgery depression, a thing I didn't know even existed.

This is, apparently, particularly associated with thyroid surgeries, although most people don’t experience it. To just sort of note what’s out there, here’s a medical journal report on it:

Thyroid surgery is usually recommended for thyroid cancer and can be to remove one lobe of the thyroid (partial thyroidectomy) or to remove the entire thyroid (total thyroidectomy). Thyroidectomy may also be recommended for certain non-cancerous disorders including hyperthyroidism and large goiters. The results of a total thyroidectomy is hypothyroidism which requires lifelong treatment with a thyroid hormone pill. Several recent reports have highlighted a decrease in the quality of life and an increase in depression in some patients with hypothyroidism due to thyroid surgery. Therefore, the authors have examined if there is an association between thyroid surgery and a new onset of depression.

Great.

Apparently post-surgery depression is a thing with older adults anyhow, and I’m 60.  But to make it even niftier, depression is even more associated with colon surgery.  Another medical journal notes

The prevalence of anxiety, depression and PTSD appears to be high in patients who have undergone colorectal surgery. Younger patients and women are particularly at risk.

I don’t know the cause of all of this, and there could be a bunch of them that occur to me, some of which actually wouldn’t explain it in my case.  But being honest with myself, one of the things has to do with a family history and my early life.

Anxiety of a type is a condition which occurs on my mother’s side of my family.  Not everyone has it by any means, but some do and at least in one case, my maternal grandfather, it was really noticeable.  He was by all accounts an extremely intelligent man, but as a young man he suffered enormously from anxiety which kept him from building a career at an age, in that era in particular, a person normally did, and which in turn kept him from marrying at an age when people normally did.  My grandmother was his fiancé forever, and its actually a bit surprising that she waited for him, but then she had her own background haunting her, that being that she was highly educated and intelligent, but her own mother was not particularly fond of her, and was open about it.

Ultimately my grandfather found a career in real estate in Montreal, and did well until the Great Depression. When the Great Depression hit, and funds trailed off, he turned to drink, something that plagued him for years.  Remarkably, probably in the late 40s or early 50s, a Catholic Priest apparently told him to stop drinking and he did then and there, cold turkey.  Even more remarkably, my Grandmother suffered a miscarriage with what would have been her eighth child and went to a Priest, maybe the same one, and asked if she could stop performing the Marital Debt.  He said she could. That means that my grandfather, for the last ten or more years of his life, didn’t drink anymore, which is where he had taken refuge from stress, and also lived in a sexless marriage, which must have added enormously to his stress.  Amazingly, he seems to have actually pulled his act together, and lived out the balance of his life as a happy guy before dying at age 58.  His siblings, however, never got to where they trusted him and that ended up being taken out, after his death, on his widow and surviving children.

That’s an extreme example, of course, but there are a couple of others.  Something afflicted my mother, but nobody has a clue as to what it was.  She recovered from a condition pronounced to be terminal, and therefore the early diagnosis was either wrong, or her recovery was miraculous (which is what I think it was).  Her recovery, while real, was never complete, however.  As another example, one of my cousins on this side of the family, named after my mother, and one year older than me, was so conscious of anxiety being a factor in her makeup, she purposely chose a scientific lab career in order to avoid it.  In her early 60s, the impacts of this have not hit her, but she’s dying of cancer presently.

I know now that anxiety has impacted me my entire adult live, although largely unacknowledged by me.  I don’t recall it being a factor at all until I was an adult, but the trauma of what I went through as a teen probably didn't help, long term.  The first time I really experienced it was when I worried about going to basic training, but I got over it quickly when I was there.  After that, it became clear to me that I experienced travel anxiety, which is a condition that is something that uniquely occurs in some people.  It’s hard to explain.  Ironically, I've traveled in my adult life a huge amount, and generally like where I'm going, once I'm there.

It’s when I became a litigator that I really became conscious of anxiety, however.

Litigation is an extremely stressful career as it is.  Anxiety runs rampant in the field.  According to the ABA, for lawyers in general, a study revealed:

• 64 percent of lawyers report having anxiety.

• 28 percent lawyers suffered from depression

• 19 percent of lawyers had severe anxiety

• 11.4 percent of lawyers had suicidal thoughts in the previous year

And that’s just regular lawyers.

There have been study after study on this topic, and they all come about the same, with some coming out much worse.  I’ve seen one article that has dissed these findings, but just one.  My guess is that probably double these figures (except for the self reporting anxiety, which would amount to a statistical impossibility) would be the case for litigators.

Indeed, I’ve long noted that most litigators actually won’t try a case.  I have tried a lot of cases, and one of the reasons why is that I’ve always been conscious of the duty not to allow a person’s anxiety to keep them from dutifully fulfilling their duty to their client.  I”ve sometimes worried, in fact, that I might possibly try more cases than others in order to counter the fact that anxiety might be infusing my views, but I don't think that's the case.  Anyhow, anxiety in litigation is so bad, as noted, that a majority of litigators actually won’t try a case.  I've always just been aware that it was there, can impact how you think, and set it aside.

In other contexts, I’ve long seen the impact of anxiety working itself out in destructive ways in the legal field.  I’ve known lawyers who were drug addicts or alcoholics, or who engaged in other destructive life choices.  I’ve known two who quit practicing due to anxiety, one self-declaring that and the other just not being able to overcome an addiction to alcohol otherwise.  One really well respected plaintiff’s lawyer actually disappeared from his household and family for a couple of weeks until he was found in a hotel in another state where he’d gone on a profound days long bender.  Three I’ve been aware of just disappeared, two resurfacing in a seminary and one in the People’s Republic of China.

This all being the case, while I’ve been a successful lawyer, law probably wasn’t a field that I should have gone into.  One lawyer friend of mine from Germany, whom I remarked to on this, dismissed this, saying “you are an intellectual, your choice was to become a lawyer or a priest”, which is an interesting way of looking at it, but had I been smarter, I’d probably have chosen the path of my scientific cousin in order to avoid the stress.

It doesn't matter now.  Like the Hyman Roth character in Godfather II, "This is the business we've chosen".  And by and large, it worked out well.  Being honest with myself, I've been able to do a lot of interesting things, and have constantly learned new fields and topics, all the time.  If you are an autodidatic polymath, it's hard to imagine a field that would actually offer so much as the law.  And if you do like visiting obscure places, at least prior to COVID, it really allowed you to.

In saying all of this, what I’m saying now is that looking back on the past horrible year, I can look back decades and see the points at which the stress rose up and made me act in ways I never would have, although never in a professional sense. Each time, really, was a cry for help, but cries for help don’t really come through that way if they’re not posed that way. And sometimes, there is no existential help, you just need to pick up your pack and carry on.

This past year, however, with the fog of post-surgery depression setting in, I was really unaware of it.

I should have been, as I didn’t mentally feel right.  I did keep mentioning that “I feel slow”, but that means you feel slow.  The real warning was when I absolutely exploded on two partners who have been keeping a long running irritating argument going for years, permanently ending it.  It needed to end, but blowing up on them was the wrong thing to do, and in retrospect I’m amazed that I wasn’t told to take a hike.

In Catholic theology there’s something called “the problem of evil”, which boils down to “why does God allow bad things to happen”. There are various answers to that question, but a universal partial response is that God doesn’t allow something to occur if he cannot bring good out of it.  In our temporary lives that can be awfully hard to accept, but I believe it to be true.  In this instance, I can now in fact see this at work.  In a way, this allows me to go back, but clear minded, to the beginning of my career as I now approach its end, but to be a kinder, more thoughtful person, and a more grateful one.  I do believe that people can and do change if they wish to, and while it’s not as if I’m now going to become an Iron Man competitor, or something, I am in a way following a bit of the same path taken by a friend who was very bitter about his legal career, and openly so, but in the last few years has become very grateful for it.  I have a lot to be thankful for.

I also have the chance now to beat anxiety that was lurking there, rather than to sort of give into PTSD, which is basically what I have had in a way.  That condition, known as combat fatigue originally, or shell shock, has been determined to be much wider than originally thought, and the frequent comparisons of litigation to combat are pretty accurate.  But knowing what’s what is frankly more than half the battle.

Part of that also I think is following a bit of what Alcoholics Anonymous and other addition programs have in their “twelve steps”.  I’m not saying I need to join AA or NA, or something but rather the page AA took from the advice of a Catholic Priest, which is similar to what Jews do on Yom Kippur, is to apologize to people you’ve hurt.  I’ve done that with four people already, which is probably the set I needed to.  But beyond that, part of it is being more tolerant to the people and conditions we routinely encounter, something that is difficult in a judgmental profession like the law.  

So, in the end, I’m grateful to have an outside professional let me know what was going on, and that its connection to surgery, twice will remediate, and indeed already are.  But beyond that, I’m grateful for the door it opened and which I’m walking through to be more aware.

Pax vorbiscum.