Relapse, Try Again
So I relapsed.
Taken by Surprise
After going through this routine once or twice (three times now if anyone's counting), I imagined that I could easily spot a relapse and dispatch it judiciously. This was not the case. In retrospect it might seem obvious that something was amiss. As I had begun to feel progressively better, I had an undoubted confidence that I was making incremental progress each week. The tasks which I could perform but previously couldn't were easy to enumerate. I had been practicing the saxophone religiously, writing here faithfully, even if not eloquently. Just more than a month ago, that quickly changed.
- On September 25th, my contributions to this catalog of my thoughts derailed. I was practicing so much saxophone however, that this seemed to be merely a reallocation of my time and concentration, not portentous of a precipitous decline in cognitive function.
- Shortly after I noticed that cologne, most foods, and other things smelly became conspicuously less fragrant. Even when the deck of my parents house was being painted, and others where complaining about the odor of the paint wafting in through open windows, I could hardly smell anything.
- Eventually it became apparent that the zealous, frantic progress I had been making on a number of new musical compositions had totally stagnated; additionally, I stopped hearing music in my head with the frequency or clarity with which I normally do.
- Finally when I couldn't listen to more than 5-10 seconds of music without getting lost, had trouble orienting myself with respect to the days of the week, and had stopped playing music altogether and had begun again to lose visual cognition(approx October 30th), I incisively deduced that my condition had begun to relapse!
In reading Oliver Sacks' The Man Who Mistook His Wife For The Hat, I was amused to read a passage in which he relates that when a man loses a leg or an arm, he is aware of it, but when he loses a part of his 'self' he often cannot recognize it, for that part of the 'self' is not there to recognize its own absence. While this might be an overly simplistic abstraction of he physical processes governing the cognition in a sense of identity, my own situation aligns with this observation startlingly well.
When I had relapsed, just as when I initially fell ill (and when I relapsed the first time), it was only when I could point to some obvious fact or measurement that I knew for certain that I was not myself. When I could point to blurry vision and say, I know I could see this clearly yesterday, then I knew I had relapsed. But as for the sense of being: even though the actual sensation of being alive and thinking has changed so much, shockingly swiftly in response to steroids, as I decline, I cannot tell that it is slipping away.
Why is it so easy to notice when suddenly I am endowed with cognitive powers that I had lacked for months, but so difficult to tell when I am being stripped of cognitive powers which I have had for two decades? Why am I taken by surprise every time my condition defies the imperatives of my army of anti-immune-system biochemical weapons.
A Great Progress
One notable thing was different this time. Empirical findings confirmed objectively the dysfunction that I had probably been reluctant to admit to myself, in part out of some vestige of paranoia that it truly could somehow be merely psychological and not neurological. The knowledge that my progress can be gauged, if crudely, and that a relapse can be detected with instruments serves the dual functions of emboldening me to be more candid with myself in considering the possibility of a relapse as well as providing a way to circumvent the pitfalls of relying exclusively on my necessarily subjective assessment of my own neurological well-being.