Delta

Like a river spreading out across its floodplain, my deltoid ligament spreads out across the middle of my foot. It keeps my leg joined in many ways to my foot, and so complex are its attachments that even the anatomists are not agreed on what its components are.

You can damage or hurt it by running downstairs, or landing on uneven surfaces, or dancing vigorously, and in many other ways. But the first two ways are the ways in which I hurt my deltoid, and the pain grew. And grew. It is no ordinary sprain, but something almost existential — for without the deltoid ligament, one cannot put one's best foot forward without some instability resulting.

Losing Face

I have a terrible hypertrophy of the jaw muscles. It has taken some years of unconscious jaw-clenching, but finally, I have noticed the bulges that result from that practice.

It is bad that I have learnt these things too late. My face is stretched and malformed by the kind of artificial patience that owes nothing to natural temperament and too much to the capacity to grin and bear it. My stiff upper lip is not British, but from brygmoidal pain.

Similarly, my stiff-necked behaviour comes from trying to remain unbowed beneath the burdens of the world. Since I noticed this, I've learnt to be more humble. Bowing the head is preferable to breaking the neck.

And so, slowly, my face has sagged into anonymity. Life is good.

Pain, Brain, Train

Just as the rain in Spain falls mainly on the plain, so also when we train we hear all the time, "No pain, no gain." But associations aside, it's actually hard to disentangle the brain from the pain when we train and so on.

It's very simple. The concept of mind that we have is a very iffy one. 'Mind' to us involves emotions (which are the result of your whole body's physiological changes) and reasoning (which often involves the immediate biasing effect of both internal and external environments). It gets even iffier when we look at the fact that physical action biases sensory and emotional perception.

In a recent experiment involving 38 subjects, Psychological Science reports that people who took four steps backwards before attempting a task did better than people who took four steps forwards. Similarly, in this month's Scientific American, another experiment showed (not for the first time) that the configuration of the mouth and lips affects how a person hears things; if you are smiling, you are more positive than when you are not!

The body's input to the brain's filters is significant. When I pull my shoulders back, I know I still feel pain, but the pain gets more bearable. In fact, it's easier to forget the pain when I breathe deeply and slowly and smile a lot.

For all those students of mine who wondered why I used to walk so stiffly upright and smile so much, well, that's one answer right there. Then again, I prefer to walk properly and I'm a generally happy person, so perhaps it's not the only answer.

Asymmetric Haunting

These things come back to haunt you.

I've realised that over the years, every unilateral injury I've ever taken has been on the right side of my body. Shoulder, foot, various ungainly ruptures of connective tissue and integument, either to the right side alone or to both sides.

It's a bit like what they used to call 'warrior wounds', mostly on the non-shield side. The thing they never tell you is that the muscles develop warped, trying to compensate for problems of balance and mobility.

Some of my right neck muscles, for some reason, are about double the diameter of their left neck counterparts. My right shoulder has an annoying habit of moving forward faster than my left shoulder, and my right knee is bigger than my left.

I would never have noticed, actually. One day, though, I was doing stretching exercises on the floor when I realised one reason I couldn't stretch as far in one direction was that one of my legs was about 8 mm longer than the other and the other was chunkier.

Over the years, my back muscles have tried to compensate for the slight skew in posture. As a result, almost all my back pains are on the right side, both upper and lower back. The only time I have no back pains is when I've been relaxing in the water a long time or when I've had a particularly good massage.

Nowadays, when I hear about the injuries people like JJ and Tim have suffered, I feel sorry not because of the immediate trauma, but because I can just imagine what it will be like two decades or more later.

These things never really go away. But the haunting intensifies, as if they keep reminding you, "Hey, you killed us when you were younger; now, you will never be free of us." Sigh.

Asymmetrical (Redux)

Apart from information asymmetry (which the High Priest of Atlantis mentioned on Saturday night as well), there is another kind of asymmetry I've come to think about more and more. This is somatic asymmetry.

The word 'somatic' comes from Greek soma, which means 'body'. 'Psychosomatic' means 'pertaining to the link between mind and body', for example.

We're often taught that the body has bilateral symmetry; that is, the left side is a mirror image of the right. Various studies have shown that people think of symmetrical body-forms (somatotypes) as being more beautiful or aesthetically pleasing. So far, so good.

However, the body is actually asymmetrical from the beginning. Wherever the heart forms, the lung on that side becomes smaller; most people have a two-lobed left lung and a three-lobed right lung. On the side where the heart has formed, the stomach also grows; on the opposite side is the liver.

A careful look at all of your body will reveal that the body is actually casually and superficially symmetrical, but internally and on close examination slightly asymmetrical everywhere. Most people have one leg slightly shorter than the other, a preference for the right side over the left, and asymmetrical placement of organs one would think should occupy mirror-image locations. (Think of all the organs, glands etc which are paired. Now look at them and compare, where possible. You'll see this is true.)

This is consequences for many of the activities we take for granted. Our shoes wear away slightly more on one side, our musculature eventually suffers from compensating for different angles and masses on either side of the body. As the knees and other joints develop differently, the effect becomes more pronounced. By 40, most of us will be lopsided and think it perfectly normal.

It's part of diversity, I suppose. Diversity begins at home.

Sleeping Positions III: Down & Out

Sometimes when totally exhausted, I flop out face down and have some marvellous sleep. It's not just anyone who can sleep face-down: you need to have the means of breathing. Fortunately, I have huge nostrils and they always allow me to get enough oxygen even when sprawled on my face.

There is one exception: if the bed is too soft, I find that a not-completely-face-down position is necessary for the continuation of life without oxygen deprivation.

Apart from such considerations, face down and dead to the world is quite a pleasant thing.

Sleeping Positions II: Fearful Asymmetry

I used to sleep flat on my back. I find it hard to tilt and twist my spine; it's funny that my torso should be so averse to torsion. But these days, people say I snore when flat on my back. Heh, it has never troubled me before.

I've seen others curled up in foetal position, like little prawns wrapped in cloth skins. I wonder how this can be comfortable, while uneasily realising that I must have spent quite some time in that position too.

I see advertisements showing mattresses and pillows that let you sleep naturally on your side. That always profoundly upsets me in some atavistic way. Can it be natural for one to sleep on one's side? My pets do that once in a while. But they look more alive sleeping on their bellies. It must be as natural either way.

For chordates who are also vertebrates, it seems odd that one should lie sideways, instead of symmetrically. It seems much more natural to put even stress on your organs, even if the human inside is less symmetrical than the human outside. I fear that when I sleep on my left side, my liver will smack into my heart and make it work harder; when I sleep on my right, I guess it helps gastric drainage, but I always feel that things are hanging over my gall bladder and as-yet-unremoved appendix.

Oh well. I'm sure Hamlet never thought of this when wondering about the sleep of death.

Out Of Joint

The beautiful articulation of my bones enables me to move, to flex, to wrap myself around terrain and pour myself over it. My joints give me the ability to change the direction of an impulse, to shift my mass, to display a kind of heterodoxy of movement. My skeleton is a defining factor, endo over exo, mobile over static, higher animal over barnacle or tree.

And on a cold wet morning, sometimes I'd rather be a tree. I have just come to realise that the bearings of my joints are not forever. The knowledge has always been there, especially since the time I tore the ligaments in my shoulder. But realisation, the event of something becoming real, is a different matter. I ache on such mornings. My joints are the main culprits. And being articulate is sometimes more of a curse than one might ever have imagined.

Toeward A Better Future

Dear Diary,

Yes, here I am again, R5 reporting in. It's a pain being someone's right fifth toe. The boss fractured my proximal phalange three weeks ago. He is pretty light-hearted about it, but I've had to call in some weight-bearing favours from those pains in Department L, and the larger phalanges here in R. And the metatarsals complain all the time. Now our calcaneus has weighed in as well – what a heel!

I'm also being exposed to blatant fascism. The downward pull of the plantar fascia is a daily irritant. I mean, it's not my fault I'm damaged. Sometimes, bosses are just not very aware of the things they do, and small components like myself bear the brunt of it. Well, in a sense I'm now getting my own back for forty years of being taken for granted.

That's not how I want to be remembered, though. I've been bearing my burdens without complaint and I'd like to think I'm an effective worker who carries his own weight and supports the organisation. My department may consume a lot of energy, but it has been useful work, and I think I provide more than my fair share of stability and balance at my end of the unit.

Three weeks after I was almost retrenched, I've been sent for appraisal. In my view, it was premature. Most of us take six weeks to recover and therapy begins after that. But bosses are impatient and sometimes subject to other pressures (yes, I know a lot about pressure, actually), and so I've been scanned. The break is still there, looking as ugly as ever.

What I'd like to tell the boss is, "Hey! There are things your kind of appraisal doesn't show. It doesn't show matrix-building or anything else except hard calcifications and mineral deposits. You should adopt more holistic methods and leave me alone for now. Stop bearing down on Department R and take a break for a few weeks. The other departments are working fine."

Instead, I tell him nothing. He's taken me for granted for many years; well, tough luck if I am somewhat uncommunicative. I'm injured now and he can't rely on me the way he used to – that's just too bad. If he never understood my usefulness, he should have learnt something of it by now. But I'm not bitter about it. I just toe the line.

In all this, I must say that R4, my neighbour, is a pillar of strength. The company made us hang out a lot together and although boss seems to think it suspicious, I think it is a good arrangement. He helps to spread the weight. I also feel bad about our departmental head, R1.

R1 has been holding things together on his side, but he seems to be buckling a little under the pressure. He's still a big player though. The organisation must move on, and to do that we must put our best foot forward. He knows that, and I think the fact that he's shouldering the responsibility (metaphorically speaking, we don't want the Army units after us) helps us all.

Ah well, it's time for my medication and for the boss to commune with company headquarters. HQ is very distant from a minion like myself. But as I always say, better a minion than a bunion.

Yours, R5.

Word of the Day: Phalange

I always thought a phalange was a digital bone, and when you clenched your fist, they formed a phalanx of bristling knuckles, or something like that. I filed that away as a somewhat inaccurate but serviceable definition years ago. Unfortunately, I was recently forced to relearn that word.

Oddly enough, I saw it in French as, "Formation militaire de la Grèce ancienne. Tous les Grecs mâles étaient fantassins (hoplites) dans l'armée de leur polis. La phalange était une formation très serrée disposée sur plusieurs rangs." Oh yes, as I thought, ancient Greek phalanx. Fortunately, there was a 'the phalange is...' version: "La Phalange est un segment osseux articulé dont est constitué le doigt ou l’orteil." Much better.

I reecently cracked the phalange on my little toe, the bone of that toe which is conjoint with the rest of the foot. I tripped over a chair, whose slender leg got trapped between my last two toes. I stumbled forward and momentum did the rest. The phalange cracked from side to side, and just like the Lady of Shalott, I cried out something which could colloquially be considered equivalent to her "the curse is upon me!"

And there you have it. Reduced mobility for 4-6 weeks. Sigh.

Old Injuries

All of you have shoulderblades. The technical term for 'shoulderblade' is scapula, which means 'cloak' in Latin. Place your left hand on your right shoulder. You can feel the top of the shoulderblade, a bony lump where your arm connects. The topmost bony process is called the acromion.

If you feel around it, you will realise that it seems connected to the end of your collarbone. That's a good thing. Your collarbone is also known as the clavicle, which means 'small key' in Latin. The connection you feel is called the acromioclavicular joint. (Anatomical language is a lot like that, and if you want to be a doctor, you'll probably talk like that too.) But it means simply that it is the joint between the acromion and the clavicle.

Seasoned doctors call it the a/c joint, unless they want to impress younger colleagues and medically ignorant friends. Or patients. Yes, patients, which is where this story is heading. Please, be patient.

Here's a very short story. Patient used to play rugby. Accident. Extremely hard impact on the point of the a/c joint. Sudden blackout. Odd thing for the pale blue sky to do, that. It turned purple at the edges, and then black.

Later, one doctor would apply force against the ligaments holding the a/c joint together, just to find out what had happened. He learnt two things: 1) patient is very resistant to pain; and 2) patient had actually separated the two bones of the joint.

The patient learnt two things as well: 1) patient is very resistant to pain and even if not, he would never allow some two-bit torturer the pleasure of hearing him express that; and 2) exactly what patient's immediate maternal ancestor meant when she said, "If you get injured, no more rugby."

Patient took six months to recover. He learnt two very important facts that would stay with him all his life: 1) it is hard to change clothes, sleep, or do many other things with only one mobile arm; and 2) girls can be very kind to an injured boy.

Patient didn't get much out of that season. One bronze medal. Three sets of torn ligaments. 22 years of shoulder pain in cold weather. And the determination to do lots of chin-ups, just to prove that he could.

Later on, the myalgia would balance the nostalgia. He would consider this a blessing. And he would smile each time it hurt, for pain is a reminder of sensation, life, mortality and love.

Hearting Inside

It's only been in the last couple of years that "I heart you" became a common term of endearment. It means (sometimes in equal parts, although that complicates the argument later) that the first person has affection for, has a great(ly) positive attitude to, is highly inclined to roll around on the floor with, the second person. It can, of course, mean other things as well.

But that's not the point. What gets me is that some people resent the conversion of (what is to them) a noun into a verb. In grouchier moods, I too feel a little of that resentment. Yet I can easily put it aside, reminding myself that if you can't stomach it, and you can't skin it alive or gut it, you can still eye it from a distance or hand it to someone else. It's not the first organ to be made into a verb; surely it will not be the last. (I have omitted some other organs because some verb forms are reserved mostly for undignified genres such as pornography or textbooks or both).

Are there any other 'organic' ways to convey one's deep appreciation of another person? Interesting question. "I liver you" sounds nice, but the opposite would intuitively be "I deliver you" which seems odd, since the latter is somewhat religious in tone and of positive semantic burden. We could try "I kidney you" but then the rejoinder is "I kidney you not" which seems more like an assertion of truth-telling than a statement of lack of affection.

What about "I lung you"? Sounds good, but "lunging you" sounds as if a preposition is missing (when it's probably a proposition that's about to be made) in a duel. "I finger you" is probably either gross or offensive (and can be grossly offensive). And "I brain you" is certainly not conducive to harmony. Some figures of speech are just too violent.

So what could possibly suffice to convey affection as deeply as "I heart you"?

I guess nobody nose.