Sometimes, my body has a strong opinion with which I disagree.

Here’s a good recent example:  My body doesn’t like getting stuck with hypodermic syringes.  When I refuse to allow my body to leave the doctor’s office and when I allow my body to get jabbed with a hypodermic needle, it retaliates by fainting.  It’s one of those things that I completely forget about until I’m sitting in a doctor’s office overly aware that I’m about to be stuck again.  At such moments, my body reacts in a way that embarrasses and annoys me.

Here’s a bit of context. For the past few months, I’ve had some nagging back and arm pain.  On a lark, I signed up for some acupuncture administered by a chiropractor. Getting stuck with those little acupuncture needles didn’t give me big problems—not that I enjoyed the sensation of those tiny needles being pushed into my back.  After three treatments, I gave up on the acupuncture because it didn’t offer any long-term effect (although each treatment relieved my symptoms a bit, for a few hours).

My next step was to see my family physician, who arranged for x-rays. He told me that I had “arthritis” and suggested some physical therapy.  [Before going any further, anyone reading this should probably email me a HIPPA form].

I was hoping for more of a pinpoint diagnosis, though, so I visited a doctor who specialized in Physical Medicine & Rehabilitation. He arranged for an MRI, resulting in some fascinating pictures that suggested that I had noticeable deformities in several cervical vertebrae and in the discs that separate those vertebrae. It is not an unusual condition for someone in his 50s, but for me it has been quite painful because it’s pushing on a nerve root.  It’s distressing to see such clear pictures of my body’s insides deteriorating.

The physical medicine doctor suggested that I might eventually want to consider some surgical options. Therefore, I visited a surgeon who confidently assured me that the pain I am suffering is due to the spinal deformities evident on the x-rays and the MRI.  It was delightful and refreshing to hear this surgeon discourage surgery, at least for the time being.

[As many of you might have experienced, many doctors are over-eager to provide you with what they offer.  For example, the chiropractor I visited, a pleasant fellow, appeared content to keep administering acupuncture, with no diagnostic images to inspire a more accurate diagnosis.  Because it is appearing that my problem is a pinched nerve caused by deteriorating bones, additional acupuncture would have been an essentially worthless investment.]

This brings me to the topic of needles.  The surgeon suggested that I consider special injections by a pain management doctor (as well as continued physical therapy).  All I had to do was get a few “injections” of a cortisone-like slow-acting drug that would be placed near the nerve root that is currently being irritated by the deteriorating cervical disks. I set up an appointment with the pain management doctor.

The pain management doctor was an affable fellow who described the technique he would be using in great detail.    It turned out to be more than simply injecting me with steroids. The procedure was called a Cervical Epidural Steroid Injection. The procedure involved a preliminary injunction to numb part of my back, which allowed a blunt-ended catheter to be pushed several inches through the inside of my body toward the affected nerve root.  The procedure is done under a fluoroscope, which allows the doctor see where the catheter is going. Nonetheless, the insertion needs to be done while the patient is awake so that the doctors can learn if they get too close to a nerve root (I would feel unpleasant sensations in my arms if that were to occur).

[Above is a fluoroscope image of my cervical epidural steroid injection.]

As my friendly pain management doctor described this procedure (in much more detail than I’m describing for you) I was sitting in a chair across from him, taking some notes.  I found it all interesting, in fact too interesting.  My visual field started to get cloudy as he spoke to me and I started to feel clammy.  I started falling forward out of my chair.  He jumped up to get my legs raised and he called for the nurse to bring in the monitoring equipment.  I was told that my blood pressure dropped from 110/60 down to something like 50/30 (I was at 80/40 for 15 minutes).  I recovered slowly over the next 30 minutes, quite embarrassed.  You see, the doctor was not administering any treatment at the time. We were not yet even in the x-ray room where the treatment was going to occur.  He was merely talking with me.

Before we had even started talking, had warned him that I was sometimes not good about getting jabbed with needles, and this was proof that I wasn’t exaggerating.  As this fainting episode proved, I’m not even good at discussing syringes.

My fear of needles started when I was about seven years old.  I remember it vividly.  I had strep throat and my mother took me to a doctor.  The doctor suddenly jabbed me in the rear end with a syringe full of penicillin. I remember the shock of this unanticipated happening—I hopped around the room in considerable pain and distress.  Ever since that time, I’ve had this thing about needles.  Here’s a side note: I once saw a documentary on TV which indicated that there is growing evidence that children can develop various forms of OCD during bouts with strep throat. Not that the fear of syringes is the same as OCD, but it makes me wonder whether there is an interesting connection among these events.

What I’ve got, then, is trypanophobia fear of needles.  Purportedly, 10% of American adults are trypanophobic. Apparently, I experience the classic vasovagal reflex reaction ” a “frightening reaction which includes plunging blood pressure and (often) loss of consciousness. This reaction generally occurs only after puberty, and is more common in men than women.” Some websites offer desensitization programs for people with fears of needles.

Fainting is really interesting.  It is a tempting place to draw a line between the intellectual mind and the physical body.  I am my thoughts and my body is that thing that (sometimes) faints.  Not that you can really draw a meaningful line; all cognition is embodied and see here and here ), but it seems like you can draw such a line. Your mind is clear that there is no danger, yet your body is not convinced otherwise and it’s panicked.  It’s trying to run away but you  (the intellectual) won’t allow it.  Nothing you can say to your body will change “its” mind.    Nietzsche has a good anecdote to illustrate this struggle:

Sometimes during a battle he could not help trembling.   Then he talked to his body as one talks to a servant.   He said to it:  “You tremble, carcass; but if you knew where I am taking you right now, you would tremble a lot more.”

[Nietzsche cited (in the Gay Science, Intro Book V) the preceding quote as an illustration of his own conception of fearlessness (attributed to Henri de la Tour d’Auvergne, Vicomte de Turenne (1611-75) a great French general)]

This tendency to get woozy and faint when I am about to get stuck by a syringe (and sometimes, when I’m only thinking about it) is frustrating, in addition to being embarrassing.  It has often hindered health care professions who were trying to give me routine treatment.

I thought I was rid of this problem.  About nine years ago, my wife and I prepared to travel to China to adopt our daughters.  In order to travel abroad, we had to undergo numerous immunization shots.  I received about eight immunization shots over three visits–I didn’t faint and I tolerated the shots much better than I had in previous years. In fact, I thought I was over the problem completely.  The last several times I received a flu shot, I got right up after the shot and walked out of the room– no hint of any problem.

Over the past few years I’ve also had the “opportunity” of holding both of my children while they got immunizations.  On several of those occasions, I actually looked at the needle going into their little arms while they screamed. For anyone who has not yet had this experience, you’ll feel intense ambivalence.  You feel very much like a good and devoted parent but at the same time you feel like a moral monster.  Your child looks straight at you while sobbing and you know what they are thinking (“How could you??!”).

But back to my main story: I am the guy who collapsed while my doctor was merely describing a procedure that involved a glorified injection. The epilogue is that my doctor sent me home on Friday to come back this week (Monday) to try again “after everything had a chance to soak in.”  He confidently reassured me that I would tolerate the procedure much better by knowing all the medical details, so that I would not be surprised at all and that I would know what’s coming next.  Over the weekend, I asked my wife to pretend that she was injecting something into my back, so I could better get used to the idea (Yes, I suppose you could say that we “played doctor”).  She used something a bit sharp to simulate the syringe.  Does this sound silly?  Let me interrupt your bout of laughing with this question: What would you do if you sometimes became unconsciousness at the doctors?

This fainting episode caused me to ponder why this happens to me.  In fact, a nurse point-blank asked me why.  I suggested to her that it is something about a sharp steel needle piecing my flesh that makes me feel all-too-mortal.  Getting poked with a syringe is an undeniable reminder that we are made of meat.  Meat that thinks.  Living meat that will die.  But the real answer is that I don’t know why this happens to me.  I can assure you, though, that it is not voluntary.  I am incapable of making myself faint, without the triggering stimulus of a hypodermic needle.

Whatever the problem is, the trigger is personal to me. I’m don’t feel faint while looking at someone else bleeding or looking at blood that has been spilled.  I don’t feel faint watching surgery on videos.   The trigger also seems to involve the anticipation.  When I suddenly cut myself, I never feel faint, even when there is a lot of blood.

I returned to the pain manage office yesterday and my doctor was ready for me, setting me up with an internal line running into the top of my hand so that the team could quickly add some fluids and magic chemicals, if need be, so that I wouldn’t faint and so I wouldn’t care about what was going on.  Ironic, isn’t it?  To remedy my problem with needles, they stick me with a needle into the top of my hand.  Here’s how they put in that line running into my hand:  “I’m going to stick you with a small needle now.  It will bite a tiny bit, like a little mosquito . . . well actually like a big mosquito [ouch].

In the middle yesterday’s procedure, my body again started fading, so they immediately pushed in a drug through that line in my hand. It worked immediately.  I stopped caring about the procedure.  I jokingly inquired whether I could get a 20 year supply of that stuff to help deal with stress at work.  Hmmm.  And maybe it’s a good thing that my body doesn’t like shots, since this fear has kept me from ever considering using street drugs that require injections!

The end result is that I’ve made it through the first of three pain injections today (the next one is scheduled for next month), but the embarrassment of collapsing during Friday’s appointment lingers on.

This episode involving needles and fainting reminded me of a few fainting stories that I thought worthy of sharing.

A buddy of mine, Jim, was in the Marines in the 1960s.  He told me that while in boot camp, he was in a long line of Marines waiting to get immunization shots. He was also a fainter, and that he was getting more and more tense as he moved toward the front of the line.  Eventually, there was only one guy in front of him, and Jim was getting nervous.  Lo and behold (as they say), the guy in front of Jim fainted– collapsed to the floor in anticipation of getting his shot.  The next thing Jim knew is that a big drill sergeant ran up and started kicking the poor guy (who was still on the floor) and yelling at him, “Get up, god damn it!  I’ll have none of that shit here.”  The marine who had collapsed pulled himself to his feet and got somehow managed to get his shot.  Jim told me that it was at this very moment that he, himself, was permanently cured of his fear of needles.  After seeing that other Marine attacked by the drill sergeant, Jim simply walked up, got his shot and walked away without any ill-effects.

Yesterday, I told this story about Jim to one of the doctors who was treating me.  He told me that his uncle was describing the process by which his uncle obtained hair transplants (apparently, it can be a rather elaborate and painful procedure involving needles).  The guy to whom he was describing this procedure was a veteran of the Korean War who had been taken prisoner and beaten while in custody.  While the uncle continued to tell his hair transplant story, the Korean War veteran fainted. This doctor found it surprising that a man who had endured such hardship in Korea could still have a vulnerability to even the thought of needles.

One last story.  I used to work as an Assistant Attorney General.   My investigator (“Rick”) and I attended a court hearing where a criminal defendant (who we were prosecuting for odometer rollbacks) argued to the court that he wanted to withdraw his plea of guilty.  (Yes, it’s the same Rick I spoke about here). The judge agreed, but revoked the defendant’s bond and instructed the sheriff to lock the guy up pending trial.  The sheriff quickly slapped handcuffs on the defendant. I remember that look on the defendant’s face; he didn’t anticipate that he’d be locked up pending trial.   Rick (who had worked as a beat cop for several years before becoming my investigator) whispered to me to notice the sleight twitching in the defendant’s shoulder.  Rick then confidently told me, “He’s about to faint.”  Sure enough, within 15 seconds, the guy with handcuffs fell to the floor.  Rick explained that this is a common phenomenon among those who are deprived of their freedom.

I was reminded of this story on Friday, when my doctors pointed out to me that fainting occurs when one feels fear combined with the lack of options for addressing the problem.

On Friday night, I told the story of my own fainting to a friend of mine.  I could see that he was not impressed with the fact that I fainted while the doctor was merely telling me about a medical procedure.  I was in his ninth floor apartment that evening, and I noticed a view I wanted to photograph out the window.  I slightly leaned out the window and took a couple pictures.  By the time I pulled myself back inside, I turned around and saw my friend looking ashen and panicked.  You see, he is terrified of heights and the mere sight of me leaning out of the window was horribly unnerving to him (even though he intellectually knew that I was in no danger).

Yes, we are human animals, and our bodies contain all kinds of surprises.  It occurs to me that this discussion of the lack of control we have over our bodies could be expanded tremendously, to including a discussion of addictive behavior and the many manifestations of emotional affect.  Truly, our bodies often get their way against “our” better judgment, or at least they try . . .
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Since you made it all the way to the end of this long story on fainting, here’s the scene I photographed leaning out of my friend’s window while he froze with panic.  It’s a St. Louis scene looking east toward the Mississippi River in the late afternoon.  Don’t faint as you look at this lean-out-of-the-window view!