“Pain does not run just along the body but also seizes the mind,” or, How a “lucky-to-get” clinic appointment thrust Gerda into the arms of Doña Quixote

Featured image: An illustration titled Birdman by Frits Ahlefeldt (1966), a Danish hiker and walking philosopher: “I’m wondering about this world, about us and what we do and think making drawn stories and research about the benefits of walking both in words and drawings.” He publishes his drawings at the “Museum of Psychology.” The illustration is based on the 2014 film Birdman, or (The Unexpected Virtue of Ignorance). The satirical, surrealist, black humor movies stars Michael Keaton as a faded Hollywood actor—formerly famous for playing a superhero named Birdman. The film portrays the struggles he faces while trying to make a comeback by writing, directing, and starring in a Broadway adaptation of Raymond Carver’s short story “What We Talk About When We Talk About Love,” in which two romantic couples explore the multifaceted nature of love, ranging from romantic idealism to darker, more complicated emotions.

Title quote: The italicized part of the title is adapted from Ethan Hauser’s article “A Cancer Surgery and the Pain I Didn’t want to Face,” in which Hauser writes about his experience of his kidney cancer surgery and painful recovery (The New York Times, Feb 2, 2026).

GERDA LEARNS A NEW COMPOUND WORD AND DISCOVERS IT HAS TWO CONTRADICTORY MEANINGS 

Words with opposite or contradictory meanings or are known as Janus words, after the Roman deity Jamus, who has two faces, one looking toward the past, the other toward the future. Examples of contronyms are a), Bound that can mean heading to a destination, or being restrained from movement; b), Cleave can mean to adhere, or to separate. My new word is Ego Death, in which the word “ego” is defined in the sense of Jung and Freud, namely as a necessary structure of one’s psyche: your ego is the part of you that organizes your sense of identity.

Below, Freud’s Structure of the Mind

When I found my new word, it sounded to me like something bad: something like the gradual erasure of my sense of self/ego/identity as it was before Doña Quixote started appropriating large chunks of my brain. The loss of my ego has been an ongoing intense psychological crisis, a “dark night of the soul.” This indeed, is one of the meanings of Ego Death.

Above, The Sleep of Reason Produces Monsters, Goya, between 1797 and 1799. The terrifying animals around the sleeper is a symbol of reason’s frailty: the artist criticizes 18th century society for enthroning scientific knowledge as the primary way of seeing the world. Goya shows that we humans are unable to block the Unconscious, aka Freud’s Id, where instinctual desires pursue pleasure without caring about the constraints of the external world: dreams, slips of the tongue, or inadvertent bodily action demonstrate that reason cannot control the Id.

Photo by Randall J Hodges, Japanese Maple in full fall color, Portland Japanese Garden, Oregon

GERDA’S FEAR OF PAIN BULLDOZES ALL REASON FROM HER BRAIN, LEAVING THE ORGAN TO THE MERCY OF HER PRECONSCIOUS AND SUBCONSCIOUS MINDS: DOÑA QUIXOTE SWOOPS IN 

First week of March: Before my 6-weeks-after-surgery-checkup with dr Spiker, I was so intent on winning the “best-septuagenarian-post-surgery-recovery prize” that I completely overdid the walking, building up from 2,000-3,000 steps to 5,000 steps (over a few days). A day or two after my doctor visit, it was clear that I had overdone the walking: my lower back- and hip pain increased in intensity, I could no longer straighten my back when getting upright.  Joining the pain bandwagon, my decades-ago diagnosed arthritis flared in two other body parts: 1), my bunions—despite multiple earlier surgeries—had caused the second toe of each foot to climb over its neighbor big toe, causing left– as well as right ingrown big toe nails.

“No,” Mrs. Kinkle. Even with a very deep root canal, I won’t be able to remove your ingrown toenail.”

Arthritis, 2), My  left thumb/wrist also ached and had no strength. Over the last 5 years or so, I’d had a number of cortisone shots, alternating left and right hands. The nasty procedure of an injection needle stuck inserted between my trapezium and 1st metacarpal bones is inherently painful. My most recent shot was the worst—the head honcho doctor at the orthopedic center gave it to me. Excruciating. I gripped nail marks into Peter’s hand, cried tears onto the desk-like work table at which I sat. Afterward, my hand ballooned up and was horribly sore. While the swelling eventually went down, the cortisone never fully took effect.

We had plans to go out for coffee the next day but we first wanted to make an appointment at the arthritis clinic. Before my bad experience with the head honcho, I’d had 3 hand shots administered by Katie Fossen, a physician’s assistant who is specialized in treating hand, wrist and elbow conditions. They had been far more tolerable than the last one—and were successful. She was the one to call. For any appointment, I have to keep my strict time-consuming morning routine in mind: half-an-hour before I breakfast, I take  two prescriptions tablets to spur on my sluggish digestive system. Then a bowl of bran, after which I have to stay near the bathroom until about 10:30 am. Accordingly, we try our utmost to avoid any appointments before 11 am, preferably 11:30 am. If I have to be somewhere earlier than that, I have to get up 1 to 2 hours earlier than usual to complete my routine. To make appointments for me, Peter usually does the talking and I sit next to him, helping check the calendar. We were in position at his desk at about 10:30 am, my digestive routine done.  But I was still in what I euphemistically call my “lounge wear.”

Katie’s scheduler first offered appointments toward the middle of April, but then said, “Oh, there’s a cancellation for today: the 11:45 am time slot.” I rationally knew that with my  permanently broken executive function I couldn’t shower, dress, and get to the hospital in the 1 hour that remained. But I desperately didn’t want to live with the pain for another two weeks. I said yes. Then panicked: like other people with dementia, I cannot deal with surprises, even those “for my own good.” I ricocheted into a Freudian hysteria. Skipped the shower, wandered into my walk-in closet, stared at my outfits which I’d separated—Marie Condo-style—with labeled white pillowcases to ease my confusion related to real-world objects. My dementia was at the notorious stage where “many options can lead to ‘catastrophic reactions’ or complete shutdowns in decision-making.” Faced with my clothing cornucopia, I kept to-ing and fro-ing from one choice to another—and another. My attention deficit ballooned, putting a buffer between me and the demands from my rational brain. I fiddled with my phone. Even checked my messages, I who habitually ignore them! Peter’s “How far are you?” shocked me back, I meenie-mini-moed an outfit, my broken executive function scrambled the ritual fiats of getting dressed: I put on items inside out, back to front, shoes before pants.

In the car—with only 20 minutes to go,  I was jittery, full of fear, tearing up, all  to be continued in the waiting room. Once in Katie’s procedure room, I felt a bit better when she took my hand. She grasped my 1st metacarpal between her thumb and forefinger. By pressing her beautifully manicured thumbnail into my skin, she imprinted a mark for the injection needle. Following the sonar imaging, she inserted the needle.

The needle went in without pain. When it was all the way in,  she warned she was going to push the plunger: “It’s going to feel like an explosion.” Crying softly, I held Peter’s hand. When the explosion came, I imprinted multiple marks in his palm with my unmanicured fingernails. Katie pulled the needle out. The PAIN vanished. On the way out and in the car I was ecstatic—and so was Peter!

IF GERDA FELT ECSTATIC AFTER HER SUCCESSFUL ARTHRITIS SHOT, WHY DOES SHE   CONTINUE BEING PSYCHO?

The night before we would call the clinic, Wednesday, Peter and I planned a get-out-of-the-house -and-smell-the-blossoms excursion for the next day (Thursday) to an upscale vintage shop, the Old Flamingo, which  I’d frequented during the years when I could still drive. Before browsing the shop, we’d get some coffee first at Roots, which shares the Old Flamingo building. However, on Thursday morning when we got the same-day appointment, we expected I’d be miserable and in pain afterwards like after previous injections. We postponed our coffee date. However, after my shot went so well, we reinstated our plans. It turned out that Roots had become much grander than the coffee and sandwich shop we’d frequented long ago. Lunch menus on tables. I blurted, “Why not upgrade to lunch?” It would be the first time I felt well enough to eat in a restaurant. Then realized it was only 12:30 pm and we usually have lunch, our main meal, between 2:30 and 3:3o pm. We’d be breaking our routine twice in one day! And the many menu choices would stymie me as usual! Before I could object against my own previous suggestion, Peter announced he was have an all-day-breakfast. I stared at the breakfast offerings spinach omelet/cranberry bread pudding/mediterranean omelet/crepes  and so forth for 2 pages… In the end, quoth the Doña, “I’ll have what he’s having.”

When our meals were on the table, my injected left hand felt strong enough to handle my fork, with my knife in the right, throughout the meal, South African/British style. A first in my history of shots. When we were done, we walked the few steps to the Old Flamingo. I was still hyped. At the entrance vogued a three-feet-plus gold and pink flamingo. It was love at first sight. It would look great among our other off kilter decorations on our balcony. Fortunately, it was not for sale, since after we got home I was very sure that it would  have made our stoep too cluttered.

At home I was going to take a post-prandial walk up and down corridor. After only one  round, my back was too sore to continue. I needed a lie-down but I’d had too much to eat. I sat down with Peter’s at his desk to see the small birthday gag gifts he’d put on his list for Marissa and Adam’s birthdays (Marissa’s a day before and Adam’s a day after our imminent wedding anniversary—this year our 55th). I did not think any of Peter’s gift choices would work. I was supposed to have searched as well, but I’d procrastinated. Self-castigation about being a failure triggers more tears. I angrily wiped them away and said, “Sorry. I’ll do a search after my rest.” About to get on the bed, I feared the pain that still came when I flattened my back. I escaped to sat my computer, checked messages. Eventually the fiery bolts up my spine overrode my foolishness. I lay down. The pain came right away. I tried different throw pillow configurations under my left knee. After about 10 minutes,  the knee pain, at least, settled down. I slept for an hour.

After waking up, I again looked for gifts. The possibilities were either very lewd or not funny. Private self-tantrum by my computer follows, silent other than my snorts to clear my nose. When I later confessed I hadn’t found anything, the snorting, weeping Doña jack-in-the-boxed again. Peter sat me down on the couch, said he was going to make us coffee. I sniffled on. After bringing over our mugs, Peter came to sit with me, passing me tissues. More weeping, thorough enough to bring relief. I told Peter the internet “encouragement meme” falsely attributed to Eyeore: “It’s okay to cry when there’s too much on your mind. The clouds rain too when things get heavy.” We laughed some, joked more. I felt a lot better. By bedtime, my hand had swollen and was throbbing next to my aching lower back and knee when I lay down. Depression avails itself of the opportunity and strikes.

 WHY SO MUCH DETAIL ABOUT A MELTDOWN SIMILAR TO THOSE I’VE HAD UNCOUNTABLE TIMES DURING MY 15 YEARS AS A DIAGNOSED DEMENTER?

A month later, my hand is working (yes!), but the emotional see-saw is still teeter-tottering. Given how frequently Doña Quixote had squatted in my head for more than a decade-and- a-half, why does this one feel so  frightening?  Because I can pinpoint the time she struck almost to the minute. Also, she’s been rather successful at batting away my “ego defenses,” largely unconscious (and sometimes damaging) coping skills that we’ learned since childhood to help us manage overwhelming emotions.” But one mechanism did kick in—I started work my feelings out on paper: the roots  of this blog post. If it hadn’t been for the gift from the universe that still helps me  find words in my head easier than locating clothes in my Marie-Kondo-styled-closet, I would not have found even the cartoons funny.

Peter and Gerda celebrate our 55 th wedding anniversary (married 1971-2026). And toasted the 3 years before,  when we lived in sin. It was amazing that on our special day my back was well enough for me to go to a restaurant again—for the second time in 8 days. This is a routine I could get used to!