By Any Other Name

By Any Other Name

In late June, I hastily arranged a trip to Illinois so that I could be with my mother during horrific-sounding spine surgery. The procedure involved removing sections of her neck vertebrae and filing down bone spurs growing inside her spinal column, thereby relieving pressure on the nerves. This pressure had been gradually decimating my mother for years, but in recent months she had gotten frighteningly worse. Her hands and feet had gone from tingly to numb, she could no longer walk or cook or dress herself, she required a catheter, and she was, the surgeon impressed upon us, one bad fall away from being a quadriplegic. The goal of the surgery was not so much to cure as to stabilize and prevent paralysis.

Because there is never a good time for these things, my trip fell during a week that our babysitter had taken off, which by more bad timing coincided with the week after the school year ended but before summer camp started; I would be leaving my valiant husband to wrangle our three-year-old son and seven-year-old daughter without normal support systems. I also was under deadline for several freelance articles. Standing on the brink of a childcare-free week and an emotional three-day trip to the homeland, I had no idea, none, how I would finish my work on time, let alone with any degree of quality. Plus, it was getting hot.

To top it off, I stumbled across a news article about a study in Nature that found that the brains of city dwellers register anxiety more acutely than the brains of country folk.

Did I mention that I live in Brooklyn?

You could say I was stressed. I said it, constantly. But was I as stressed as this guy? “Think of me as of one, even when four months had passed, still agitated, writhing, throbbing, palpitating, shattered; and much, perhaps, in the situation of him who has been racked. …” That’s Thomas de Quincey, detailing his struggles to kick opium addiction, in Confessions of an English Opium-Eater, published in 1821. Staying clean and sober is hard enough now; imagine it in the days before Narcotics Anonymous. My mother’s situation hadn’t yet reduced me to throbbing and writhing, but my sister’s worry about it had definitely manifested in her body. An attack of acid reflux and heart palpitations had sent her flying to her doctor, fearing cardiac arrest. Nothing of the sort, he told her—just a response to stress.

Stress, as we know it, is a relatively recent coinage. In the 1930s, endocrinologist Hans Selye plucked the word from the fields of mechanics and engineering and applied it to physiological reactions to stressors. A term employed in discussions of gears and girders turned out to have much to offer in describing the human organism. Today the word seems tied to modern existence, evoking traffic jams and computer crashes and insane bosses, but while “stress” may be 20th-century lingo, stress by other names—agony, nostalgia, melancholia, neurasthenia—has been around as long as humans have.

This is a point that Neal Krause, professor in the School of Public Health Department of Health Behavior and Health Education, emphasizes in his course on the stress process. Almost anywhere he looks in literature and history, he finds startling connections between old writings and modern understanding of stress.

Take Boethius, born in Rome in the year 455. He rose to a high position in the court of King Theodorick and enjoyed a long career as a respected, learned consul. Around 520, however, he offended palace officials by publishing a tract about the Catholic belief in the unity of the Trinity, which ran afoul of Theodorick’s Arianism. Boethius was imprisoned and, in 525, executed. Before he died, he wrote Consolation of Philosophy, where he tried to make sense of his bewildering, spectacular downfall. “Because you have forgotten how the world is ordered, you imagine that there is nothing but the vicissitudes of fortune. This is enough not only to cause serious illness but even death.” Today, researchers claim that a strong sense of personal control is a primary resource people draw on to cope with stress, but no one needed to tell Boethius how health suffers when you feel you’ve lost control over what happens to you. Evidently, he expected the stress to kill him. Maybe it would have, if the state hadn’t done it first.

And did the German poet Friedrich von Schiller somehow know, in 1786, about cortisol? It sure can seem that way, to read his strikingly prescient lines in The Philosophical Letters. In the fifth letter, Schiller writes of a “sensation which embraces within its range the whole spiritual being”: “If the sensation be an agreeable one … the heart’s beat will be free, lively, uniform, the blood will flow unchecked, gently or with fiery speed, according as the affection is of a gentle or violent description; digestion, secretion, and excretion will follow their natural course; the excitable membranes will pliantly play in a gentle vapor-bath, and excitability as well as sensitiveness will increase.” It works the opposite way, should the affection be disagreeable. “The internal chemical processes are at cross-purposes; beneficent juices lose their way and work harm in other provinces, while what is malignant may attack the very core of our organism. … The condition of greatest mental distress becomes the condition of the greatest bodily sickness.” Imagine doctors ordering blood tests to check beneficent juice levels, or the temperature of vapor-baths.

If the word “stress” is sometimes too lightly bandied about, its cousin “nostalgia” bears virtually no resemblance to its original meaning. Today we get nostalgic for swing music or Pudding Pops, but centuries ago, nostalgia was a serious diagnosis, particularly in wartime. Sent to far-off lands and subjected to the horrors of battle, some soldiers pined for home so intensely that they became incapacitated, even hallucinatory. Johannes Hofer, a Swiss doctor, noticed the syndrome among soldiers and named it nostalgia, “the sad mood originating from the desire to return to one’s native land.” People were believed to die of it. For soldiers in the Civil War, nostalgia could result in discharge. In his 1997 book, Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War, Eric T. Dean quotes from a Civil War manual that instructed medical officers thus: “The extreme mental depression and the unconquerable longing for home soon produce a state of cachexy, loss of appetite, derangement of the assimilative functions, and, finally, disease of the abdominal viscera—in fact, the objective phenomena of the typhoid state. … As Nostalgia is not unfrequently fatal, it is a ground for discharge if sufficiently decided and pronounced.”

There is, of course, no shortage of accounts of the torments of war. In the fifth-century B.C., the playwright Sophocles chronicled the sad fate of Ajax. Enraged that Greek leaders honored Odysseus, and not him, for bravery on the battlefield, Ajax vows revenge. But, tricked by the goddess Athena, he ends up slaughtering sheep and cattle in the deluded belief that they are the despised generals. Agonized over being fooled, Ajax, considered the greatest Greek warrior after Achilles, cannot bear the shame and mockery to which he is now reduced: “For ’tis base for a man to crave long life / Who endures never-varying misery. / What joy can be in day that follows day, / Bringing us close then snatching us from death? … Nobly to live, or else nobly to die / Befits proud birth. There is no more to say.” Judging noble living to now be impossible, he falls on his sword.

In Ajax’s day, his suicide would be viewed as an honorable warrior’s death, but through a modern lens Ajax could be seen as the earliest documented case of post-traumatic stress disorder. Even with current understanding of PTSD, the Greeks have much to teach us about the psychic toll of warfare (although PTSD can be triggered by any experience that threatens injury or death, such as accidents, violent assaults, or natural disasters). In fact, in 2009 the U.S. Department of Defense gave $3.9 million to an independent production company called Theater of War to stage “Ajax” and “Philoctetes,” another of Sophocles’ plays, at 50 military sites around the country. Bryan Doerries, founder of Theater of War, told the New York Times that he viewed the project as a public health effort to help veterans overcome the stigma of psychological illness and seek the treatment they need. If it can happen to mighty Ajax, it can happen to anyone.

In Buddhism, the first of The Four Noble Truths tells us that life itself is suffering. We live in an imperfect world; inevitably we encounter pain, disappointment, a parent’s illness, our own decline and death. Buddhists believe in, and pursue, a path away from attachment to earthly things and toward the cessation of pain, but it’s a long process of diligent practice. Contemporary stress literature suggests that while difficult experiences can be detrimental to our health, they also hold the opportunity for “post-traumatic growth.” Weathering a crisis can increase one’s confidence in weathering crises, so that next time one might experience less stress to begin with.

My mom’s surgery, on the whole, went well. For three days I was almost constantly at her side, more one-on-one time than I’ve spent with my mother since I was a child. I brushed her hair, cleaned her dentures, put in her hearing-aid, washed her face, held cups as she sipped water. I saw bags of fluid dripping into and out of her (blood plasma is yellow, I learned). In one comic episode, I yanked and tugged for many sweaty minutes until I finally slid her engagement and wedding rings over her knobby knuckle; I doubt she’d ever removed the rings in more than half a century. We’ll see how much function or sensation she regains; she’ll certainly need physical therapy for the rest of her life. Still, on the plane home I felt not only the expected relief but also a deep sense of well-being, of having been honored with a difficult task. I don’t want to do it again any time soon, but if I have to, I know I can.

De Quincey, too, ended up in a similar state of better-but-not-perfect. “My dreams are not yet perfectly calm,” he wrote. “The dread swell and agitation of the storm have not wholly subsided: the legions that encamped in them are drawing off, but not all departed: my sleep is still tumultuous, and, like the gates of Paradise to our first parents when looking back from afar, it is still (in the tremendous line of Milton) With dreadful faces throng’d and fiery arms.”

By Mary Jean Babic, a freelance writer based in Brooklyn, New York. She wrote about Professor Janet R. Gilsdorf in the the spring/summer 2007 issue of Findings.

Illustration by Brian Stauffer c/o the iSpot.com