Gazing awry at the world and into the abyss which is the uncharted terrain of the future. Navigating the chasms, heading forever onwards. Fuelled by an anticipatory excitement, who doesn't search for the anamorphic objet petit a. Nostalgia grows at the kernel of life’s perpetual loss. Equipped to vanquish! Seizing each moment with entrancement and resilience, each stride reveals complexities of being...and that was before my quest to understand Lacan and this status as a breast cancer yogi. Join my journey into the fray where the social-mind, the body and the unconscious form the fourth ring in the Borromean Knot. Where Lacancer may become Lacanswer.
Notes ♪ of the knocker – Breast Cancer with a Lacanesque Tune
MUSE – Sunburn – Monday 14th December 2015 – Now into the swing of things my arrival at the hospital seemed routine. So let’s begin the third week with some selected melodies! Rather than the shocking fluff of “random” though suspiciously on theme radio tracks, this Radiotherapy Play List is not for the faint hearted. Perhaps it will reveal a few ideas that cross the minds of a significant percentage of our breast cancer collective conscience.
MUSE – SUNBURN – Come waste your millions here, secretly she says.Another corporate show, a guilty conscience grows.And I’ll feel a guilty conscience grow.She burns like the sun, and I can’t look away. She’ll burn our horizons, make no mistake. Come let the truth be shared, no one ever dared.To break these endless lies, secretly she cries. I’ll hide from the world behind a broken frame. I’ll burn forever, I can’t face the shame. And I’ll hide from the world …
Tuesday 15th December 2015 – Have you ever wondered why each hospital has a separate radiotherapy building? This is where my crazy imagination visualises the flow of daily out patients from the start of treatment to its finish. Like following the cheery Pied Piper – convinced by the statistics that we are doing the right thing.We have to believe that it is going to make us better.Whilst it feels like Hobson’s Choice! So believe!
BLUE OYSTER CULT – FLAMING TELEPATHS – I’ve opened up my veins too many times.The poison’s in my heart and in my mind. Poison’s in my bloodstream. Poison’s in my pride. I’m after rebellion I’ll settle for lies.Is it any wonder that my mind’s on fire.Imprisoned by the thoughts of what to do…
Wednesday 16th December 2015 – Here again the persistent theme of denial is the tonic. Juxtaposed by obligation and making the right choice. In 2014 “Robert Smith and Co” played two, epic, three hour sets at the London’s Royal Albert Hall for The Teenage Cancer Trust. Let’s embrace music and boogie! Afterall it is “The Cure”.
THE CURE – HOT HOT HOT! – The second time I saw it strike I saw it in the sea. It lit up the fish like rain and rained them down on me. For a second that boat was still afloat, then everything went black. I left it underwater and I never went back. Hey hey hey!!! But I like it when that lightening comes. Hey hey hey!!! Yes I like it alot. Hey hey hey!!! Yes I’m jumping like a jumping jack. Dancing screaming itching squealing fevered. Feeling hot hot hot.
Friday 18th December 2015 – No matter how alone we feel we are 1 in 8. 1 in 8 women and 1 in 870 men will be diagnosed with breast cancer during their lifetime. Most invasive breast cancers occur in the upper-outer quadrant of the breast. No matter what we think whilst we are bound to the rads machine with our hands above our heads we are 1 in 8. There are agencies there for us. There are people who will listen. We don’t need to keep our mouths shut. Get in touch remember we are the 1 in 8, fancy a chat? Call The Haven.
The knot of the knocker – Breast Cancer with a Lacanian
Prep Day – Today began a month of no return. To use Hook’s Law, it is the point where the elastic limit is reached. The moment when any additional force (no matter how small) is enough to permanently stretch the spring. A spring that has been stretched past its elastic limit and will never return to its original shape. Note the hue of blue dye as a reminder of the SLNB which took place on October 8th 2015. See the chapters on my cancer surgery.
Anyway today, I was introduced to the radio therapy staff. Prone in my gown I lay, whilst cold, metal rulers were used to measure distances. The machine whirred and whizzed. Photographic images taken. Preparations were made. I was tattooed with three tiny dots because tomorrow radiation begins. Da da da…
DAY ONE – In dignity I walked the forty minutes to the hospital. Nurses whisked patients from the out waiting room to a changing area. Once inside I tentatively lay on the machine. My gown was parted to allow the technicians time to double check the distances. I lay still, stiff as a board. The tingles along my leg were a sign of tension and anxiety. The area of the aerola contracted as if responding to ice. Background music, Ellie Goulding’s Burn played nonchalently as I bit my lip. Hoping that radiotherapy doesn’t burn.
DAY TWO – I walked to my ten o’clock appointment. The technician required a stool to give her enough height to lean across and check my measurements. Her clip-board casually placed upon my legs. The machine was “a bit out” so the procedure was halted. Re-measuring to be “closer to the lung” it sounded a little shocking, but hey. Again radio music accompanied the process this time it was INXS New Sensation. Later in the evening, yoga, without the chaturangas gave some quiet head space. OM indeed!
DAY THREE – It was all a rush this morning so I hailed a taxi. Yesterday’s felt tip markings were still visible across my skin. The radiologist marked me again but this time with a thinner fibre tip. X marks the spot. The music was on cue. Seriously, this time the coincidence was too close to the bone. My tears fell onto the head rest. Annie Lennox and the dulcet tone of The Eurythmics with A Thorn in my Side, so apt. Humming “Run, run, run, run” I bought an emolient to nurse my wounded ego and prepare for the last session of the week.
DAY FOUR – Yes I was waiting in suspense to hear the music for today. Surprisingly I was greeted by a comfortable silence in the room. All through the week my arm had been held in a vice-grip above my head. Today I risked asking if the angle could be less painful for my shoulder blade. Relief was immediate and the session was over remarkably fast. No weekend sessions.
DAY FIVE & DAY SIX – My weekend was a respite from the intensity of the daily sessions. However in the middle of Sunday night I was awoken by an excrutiating pain on the ball of my foot. I was convinced that my poorly breast had screamed out a protest. Sure that my point would be confirmed by a glance at a reflexology map I soon discovered that the part of the foot that relates to the breast is in fact on the bony top part below the toes.
DAY SEVEN – No music to accompany me today. No gown either. Yikes, I’d left mine at home. With a smile I was directed to a pile of crisp, clean and folded alternatives. There was no doubt that the show would still go on! In the evening I attended my yoga class. My instructor had been quietly told of my situation. Today she too shared with the class her own shock. The loss of a very dear friend after illness in New York.
DAY EIGHT – How life becomes routine. The breast is grateful for emolient but I take care to shower it away the morning before the next radiotherapy treatment.
Quest for recognition – It’s Christmas – Time to Beat El Caga Tió!?
Kenosis and Someone else’s heart’s desire Or: Just plain keeping up with the Joneses
The knock of the knot – Breast Cancer with Lacanian Angles Curves Flatness
What’s yours is mine, what’s mine is mine – but don’t you want it more than I do?
One of Lacan’s most well-known expressions is “Man’s desire is the desire of the Other”? (Seminar XI, p.235). Foremost this desire is essentially a desire for recognition, or for this ‘Other’ to acknowledge us and our efforts. This dependence on the other for recognition not only structures our desires but it is our drives which essentially propel us toward trying to achieve these desires. Second, desire is for the thing that we suppose the Other desires, which is to say, the thing that the Other lacks. Yet we never know precisely what the Others’ desire is. Here we see keeping up with the Joneses’ accomplishments and acquisitions. We see the green eyed monster. The cowardly yellow belly of narrow-eyed jealousy. But the goal-post is never a static. Thus desire is a process of constantly questioning what exactly the Other has or desires to have. Our quest is to find an answer.
“The object of man’s desire, and we are not the first to say this, is essentially an object desired by someone else. One object can become equivalent to another, owing to the effect produced by this intermediary, in making it possible for objects to be exchanged and compared. Thus we are led to see our objects (ourselves and eachother) as identifiable egos, having unity, permanence, and substantiality; this implies and element of inertia, so that the recognition of objects and of the ego itself must be subjected to constant revision in an endless dialectical process.”
In Lacan, Some reflections on the Ego, 34 Int’l J. of Psychoanalysis 11, 12 (1953)
In 1955 Lacan drew a distinction between the little other (“the other”) with a lower case ‘o’ and the big Other (“the Other”). Later he uses ‘A’, upper case for French Autre, and ‘a’ lower case ‘a’ for French autre, for the little other. The little other is a reflection and projection of our EGO, our ideal-I which is situated within the imaginary order. Of course the “I” only exists in relation with a you. The big Other with a capital ‘O’ may refer to a person in an enigmatic dimension. Though more commonly, it refers to our cultural ideals and upbringing, codes of human convention that pre-exist an individual. Lacan locates this alterity within language and the law. This Other is the locus in which speech is constituted and goes beyond conscious control, (SIII, 274) we are bound by the tools of language and influenced by our global cultural inheritance which is demarcated by the location and era in which we live. “The unconscious is the discourse of the Other” (Ec, 16). The big Other is the symbolic and encompasses cultural subtleties of meaning for each of us. It is the mother, who in the beginning first takes the position of the big Other for the infant. She hears the first cries and translates them towards a meaningfulness. Meaning is built through the treasury of signifiers that are constituted by the Other.
So we know that the other signifier is never alone. The stomach of the Other, the big Other, is full of them. This stomach is like some monstrous Trojan horse that provides the foundations for the fantasy of a totality-knowledge [savoir-totalité]. It is, however, clear that its function entails that something comes and strikes at it from without, otherwise nothing will ever emerge from it. For language to resonate the body must remain sensitive to it. (Seminar XXIII, lesson of 18 November, 1975, 4).
This strikes a cord and a bark of sound is logged as metaphor. In Catalunya a custom at Yule Tide is the Caga Tió or Tió de Nadal. As a folkloric substitute or addition to Santa Claus the Caga Tió is almost the Trojan Horse of Christmas gifts. Although traditionally presents are shared on January 6th, Día de los Santos Reyes or los Reyes Magos, when the three wise men or three kings of the Orient finally arrived at the stable in Bethlehem. The Caga Tió is unveiled for the lead up to Christmas and its ritualistic nurturing begins on the 9th of December. This is just after the “puente” or mini break – the bridging days between December 6th El Día de la Constitución and December 8th el día de la Inmaculada Concepción – the day of Immaculate Conception.
The Tió de Nadal is a Christmas log that stands like a pet often on four legs, with a wide smiley face painted at one end. It wears a festive red Catalan barretina hat and is covered by a warm but mysterious matching red blanket. From December 9th until Christmas Eve the Christmas Log is brought food and milk each night. As it is fed so its volume grows. Extra logs are clandestinely placed under its blanket until the evening of December 24th Nochebuena or Christmas Day.
At this time the fully “grown” log is given centre stage and the children gather around. Underneath the logs have mysteriously and secretly been replaced by Christmas gifts. To build the excitement and continue the delay in receiving his wares the children sing songs culminating in the “Caga Tió” song. Meanwhile they are encouraged to vigorously beat the Caga Tió with a sturdy stick until the blanket is slightly stripped away revealing the edges of the “pooped out” presents. The song finishes with a crescendo of “Caga Tió!” (Tió meaning uncle and cagar meaning “to defacate,”) and the little gifts of sweets, nougat (turrón), fruits, figs (higos) or wrapped-up treats (regalos) are revealed. The log has been beaten to sh**. Sometimes the children leave the room to pray or chant for the Tió to deliver more presents. Naturally this gives the adults a perfect opportunity to slip some more under the blanket. When all the presents have been pooped and retrieved, the Caga Tió has completed his task.
To assist the adults in terminating the delivery of delicious poopiness to the eager youngsters, an unappetising salted sardine, garlic clove and onion are often the last to be uncovered. The Christmas Log may then be joined with the Christmas Tree (árbol de Navidad) which itself may conceal more gifts for the family on Christmas day or on the Day of the Kings. Of course these gifts may well get swapped around because children rarely want what they’re given – they’ll always hanker over someone else’s heart’s desire.
This image of waiting followed by pain as a sacrificial step toward a fulfilment has a sado-masochistic structure aligning with a deferral of satisfaction. The repetition of investment and expenditure acts as kenosis, a need to fill what is empty by repeatedly replacing what is lost. One needs to feel an emptiness in order to be driven to fill up. Waiting is an appeasement of the anticipatory promise of more, suspending fulfilment. The excitement is in the wait not the receiving. The children believe in an expectation of something more if only they wait long enough and indeed pray. Momentarily, prayers, chants or wishes fill the gap and subdue the lack. By extending their wait the big moment is put off and their pleasure is further deferred. Almost a metaphor for The Wait. The momentous wait for the ultimate “coming”…. Or going in this case!
The knock of the knot – Breast Cancer with Lacanian Angles Curves Flatness
Instead of the shared human experience of nuanced words and creative art, games and individualistic gadgets have filled the void with their repetitive usage by addictive button pressing, promising the reward and comfort of more of the same: enter candy-crush, FB, The Witcher, soda-stream, Nespresso, coke dispensers! Cue gadgets to pine for, to choose, to contemplate, to buy, to replace with a new shiny upgrade until the consumer, consumed by them, feels inadequate and so the cycle begins again! The repetitive want for something else, the choosing, the contemplating, the hankering, the buying. As our senses are dulled, art itself appears marginalised. The letter and lick of a stamp is replaced by emoticons, jargon and moving screen-savers. Have you backed up, saved, locked your work with encryption?
This “Jouissance en toc” (Lacan 2007, p.188) is a shoddy, phony or pseudo jouissance where the world is replete with gadgets and where words have often become the poor cousin, a goggled doppelganger, unoriginal parroted wort-vorstellungen, (word-presentations), texted shorthand – or fasthand. Here language per se has become tone-deaf. Even an exploration of the pre-conscious-conscious mind, a contemplation of sachvorstellungen, (“thing-presentations”) is suffocated by the rush of time and hand to mouth immediacy of products that placate and comatose. Žižek writes about the “unfathomable excess” of the Other that has provided products deprived of their malignant “exciting” properties: coffee without caffeine, cream without fat, beer without alcohol…virtual sex as sex without sex. Political correctness has led us to “tolerant liberal multiculturalism as an experience of the Other deprived of its Otherness – the decaffeinated Other.” In this way the “traumatic Kernel” of the Other is left aside. We engage with a representation or choose to disengage and perhaps read a “re-blogged blog” of a blog.
With more political correctness we have policed our own minds. Our days are so filled with the need to use and pursue ‘stuff’ that perhaps our clogged vocabularies are taking a back seat. We have less foot-room to move in. Our words are constricted by keyboard character limits. Our minds have a limited excess-baggage allowance. Our time gives less permission for musing upon that gap of the unthought: before thoughts are born. Lacan deemed writing un appui à la pensée, a support for thought. Musing is a powerful ally, where words are mightier than the sword, double edged sharp or blunt. The pen is the staff of Moses which when let to slip becomes the snake. A lapus calami, or slip of the pen! Language is beautiful, cathartic. And what is “la langue” (the tongue or code) without “lalangue”, without that special dimension of onomatopoeia, metaphor, metonym that raises signifiers from an initial trace into an energy drive: the recipe for jouissance.
In psychoanalysis “knowledge is under construction” (Lacan S.XX1) and the psychoanalyst risks getting entangled in the Lacanian Borromean knot because the separation of langue with lalangue is impossible. For the speaker, analysand, or parlêtre, the tanglement of ‘jouissance-saturated’ meanderings of lalangue are the essence of the symptom. Lalangue resists an immediacy of meaning – it challenges by evading the communication of a simple symbolic representation. In the symptomatic moments of lalangue, language becomes owned by idiosyncrasy. It entertains the speaker and listener, the writer and/or the reader by provoking an enjoyment.
Milner in (Arrivé, 1992) states: “Thus everything seems simple: lalangue is real, langage is imaginary, langue is symbolic. And yet everything is very complicated: in the literal sense, for we are dealing with layers piled one upon another” (1983, p.40). In “Rome’s ‘ Speech” Lacan places the problematic of the unconscious in a concept defined by the rules of “langage” stating `the unconscious is the speech of others’. Is this not how the representations of our world come home to haunt us? And isn’t it part of our humanity to share our personal representations and some still get a kick out of the marks we make. Badiou (2009, p.133) references Miller’s vanishing entity or the inconsistent totality:
It is only when the mark disappears that its place appears, and therefore the mark as such. Is this enough to justify our saying that it attains its being only in its disappearance – that it takes hold only on the border of its lack – in a flash? (…) the being of the mark just like that of lack, “exists” only in the in-between, incorporeal, ungraspable, or in the difference between the one and the other, in the movement, in the passage, and it is always either too early or too late. (…) This process – this entity – presents itself as untotalizable – or a contradictory totality, which is to say, a totality with its contradiction, or with its non-integrable element, multiplicity irreducible to a unity. (…) The mark (…) doesn’t consist (it is inconsistent,) it persists, insists, it is a process. 26
Milner, et., al, (2015, p.33) in For the Love of Language and at the risk of pressing the point for too long,
“linguistics is never sad, that adjective which in French suggests the pathetic, the depressing. For linguistics has its thrill peculiar to it. That every true linguist knows, and if it cannot be transmitted directly to another, it can be read, can be reactivated, for those who are able and persistent enough to decipher it, in the formal intricacies of linguistic argumentation, whenever they successfully touch the real, whenever lalangue yields to the linguist a glimpse of the knowledge of language.”
Nevertheless, whether it be through the word or the gadget, Lacan’s symbolic order is our “translator” it is our cultural lens with which we understand and communicate in our subjective world. Its effect is first felt as our principle carer interprets our wants and needs. In those early years the presence, the gaze, the “attachment” and often telepathic servitude of our carer, the nebenmensch, is slowly exchanged for the efficacy of words over mollycoddling acts and pacifying gadgets. The satisfaction – that dwells in the first primary object, the first jouissance, Fink’s J1, derived from the archetypal infant-carer – is cut. Here a distinction is necessary between the jouissance of the body that can be summed up in the expression enjoying oneself and phallic jouissance, that of the “speaking being” as epitomised by lalangue in the previous section. It is not weaning but the teaching of language dependent on the first words that serve to sever the infant’s intense libidinal investment obstructing its object cathexis and stifling the symbiotic mother-child relationship. This castration from the mother brings about the primordial state of loss as the harmony of the infant is being fractured by the introduction of language. Lacan insists that the phallus is a signifier. It is not an image or bodily organ but a metaphor for power, particularly the power of language. Once the individual immerses in it, they become cut-off or castrated.
It may be poignant to reiterate here that it is not that “the pen is a metaphorical penis” (Showalter, 1981, p187, in Jeftić, 2011)) rather the pen is the metaphor for language, in the sense that it wields the power: power of marketing, writing, discourse and communication. This phallic jouissance, jouissance of the word, Fink’s J2, is born in childbirth to create the first hommelette Lacan, Seminar, XI, , p. 197-198.. Jeftić, (2011) explains this as “the dual nature of the ego that is broken into two halves like the egg, to the m(O)ther, the symbol of creation and new discourse. The main sense of jouissance is not only the pure, simple pleasure, it is also the surplus of pleasure that arised from the prohibition.” Jeftić in Epiphany: Journal of Transdisciplinary Studies,Vol. 4, No. 1, (2011, p.69). Later the borromeanknocker will return to Lacan’s concept of “hommelette” or little man, in an attempt to unpick an understanding of the lamella.
The realm of language as the “law” cuts subjects off from immediate bodily (somatic) experience because now all relations are mediated by words and representations. Frustratingly word-representations can never perfectly depict the first hand somatic experience, there is always a short-fall. Castration is complete when the child recognizes lack in the mother. Her maternal omnipotence is annulled as the infant realises s/he is not the focus of the mother’s desire. The paternal “No” Non (No) and Nom (Name) introduces “the law” of prohibition – (parents have lives, work, friendships, commitments and not least a need for privacy/intimacy) indicating that the life of the couple is off limits and out of bounds to the infant who is faced with a multitude of signifiers to assimilate. These signifiers stem from the wider world or authority of the “big Other” introducing public convention and the communal property of a multitude of signifieds. Signifieds as representations that lead us further into the symbolic: representations of representations of representations yet strangely to rarely become lost in translation.
The prohibiting function is upheld by Lacan’s “name of the father” a symbolic father as an authoritative figure recognised as being of either gender but taking a dominant patriarchal role. This “law of the father” is where boundaries are created and negotiated through speech, pivoting around power, command and abeyance. Lacan’s idea that sexual difference is not biologically innate but established through language and law is not framed as social constructionism rather indicative of: individual identity, social bonds and the instable drives that attach us to people. As transgenderism becomes more polemic the phallo-centric dominatrix of ideals reinforce the power of certain groups. On acquiring language and entering the symbolic order, an individual is seen and constructed as language as well as by language, they may take a phallic power role: that of historical masculinity with a sense of having the phallus of power e.g. Margaret Thatcher. Or they may take the more seemingly submissive reclining feminine role of being the phallus: the one who attracts, dazzles, who draws the power bearer, becoming the flower for the honey bee, or the queen for its workers, master to its follower(s), who live to serve.
Even without considering this added Lacanian “sexuation” in our commune with others, it is never possible to be wholly understood. We can never be certain that our explanations reach the nub, or hit the mark: the bullseye. There is always a void, a gap between oneself and another self. The symbolic order opens an awareness of a constantly nagging absence. That je ne se quoi of something missing: the memory of that first perfect cathexis with the mother or the word that misinterprets vorstellung, that just misses the lived experience. This hole in our lives creates our drive, our search toward adequately finding a shape that fits the missing gap. Our desire is in the pursuit of an objet a, this something to want, to hanker over and yearn for, to aim for. And it is the steadying of the aim that propels us forward not the accuracy of hitting the bullseye. Zizek reiterates how Drive “knows” that the shortest way to attain its aim is to circulate around its goal-object.
(Zizek states, “One should bear in mind here Lacan’s well-known distinction between the aim and the goal of drive: while the goal is the object around which drive circulates, its (true) aim is the endless continuation of this circulation as such.”)
In Seminar XVii, 33 Lacan alludes to our accumulation of signifying chains, our veritably bulging cornucopia of meanings. And this of course pre-dating our google thesauraus of words or creative commons of images in flickr. Lacan muses on the quantity of signifiers. It seems helpful here to view the topographic illustration of Freud’s View of the Human Mind as a Mental Iceberg. Indeed we may make comparisons with the iceberg concept of culture and Ernest Hemingway’s belief that the truth in writing is not evident from the surface story because the depths lie below the surface. Lacan considered the unconscious to be “structured like a language” and perhaps the complexity of this notion requires an extra moment – because language is responsible for smothering of the subject as it disappears in an aphanasis behind the signifier. However can I ever describe what I wish to evoke! Once freed from me it is out-there – set loose to be read or heard however inadequately.
The objet a – jouissance as the misencounter – the journey not the destination!
The knock of the knot – Breast Cancer with Lacanian Angles Curves Flatness
From diaries, to jottings, poetry, stories, and essays, I write. These next chapters are written in this strange time afforded by my “affliction” by breast cancer. I write to unveil my interpretations from readings of Lacan. My aim is to attach my embryonic understanding of Lacan to the depths I feel around me and deepen them. I hope to spread my love for Lacan and hope that my connection is valid. As I write, I read and as I read my ideas gain clarity. I feel Lacan. I don’t of course get it all, who does, but sometimes I think I’m most certainly on his trail. Of course there will be cross references but I hope to create something more refreshing than just another interpretation! Be my guest: enjoy my symptom!
Those who write – Write. It isn’t true that you have to be published to be a writer. It isn’t as easy as that. Wordsworth wrote about the evanescence of “it” and how finding what to write (and more so how to write) is part of the disciple’s process. Yes, process over product, because every decision, every path, every choice made is a direction taken. Yet the closer “it” gets the further away “it” feels, the epitome of the lost object. Less about discipline and more about repetition – albeit unsatisfying, unsated (and insatiable), unaired, and unappreciable: a repetition in and of a solitude. By teetering on the edge, the rim, the boundary, the writer ruminates into a void, viewing the lack in contemplation of the never ending journey without finding its destination. Wondering lonely as a cloud – wonder, wander and the mystery of where, what, why in the objet “a” that is never fully met, a misencounter: always as “Alice” might say, just a hare’s brea(d)th away.
In the first instance writing is for whom? Do I write for myself? Yes, it is a compulsive need, a part of me. Founded upon a chromosome, my own genetic imprint, established over generations, millennia even. Life is not lived in a vacuum. How can we communicate without a common language, a recognised base? Our natures are not without nurture. The past creates the future and forms who we are. There is a connection to all who have lived. Who are we without others, an other, the Other?
Our cultural scripts and schemas are termed by Lacan “the Other” and we use these to navigate the mine field that is self presentation and societal interpretation. At certain times this has more importance: how we speak, sit, eat, interject, flatter others and accept their compliments has more meaning in (for example) the work place than with friends. Presentation and representation are they two sides of the same coin? To speak or not to speak? That is the question. Ecclesiastes states, “There is a time to be silent and a time to speak.” Who is to judge when to do what? How can we guarantee that what we say is what we mean or what is heard is what is meant?
Unlike speech, writing requires no immediate response and the act of writing sits on a spectrum of spontaneity: is there not just plenty of time to hone and perfect, before an editor or publisher’s print? Imagine repeated marks on paper, the obsessive’s act of committing thoughts in an inventory. The filling of an industrial size wastepaper basket: a skip that preceded the press of a word-processor’s backspace. That’s a lot of effaced papyrus if the first go isn’t “it” – if it is premature, incomplete, not good enough. Let’s skip once more, let’s press again. After contemplation, writing begins with a possible
surge or drip (ha ha) from the faucet… out of nothing when nothing is something then into nothing or something again… it forms in a coherence that has been (s)welling and is planted upon a blank medium. The cave wall, the screen, the sheet, the tablet is the container for getting one’s inside thoughts outside. Organically nurturing and tending the tendrils of the subject which extends – growing and taking-on the spectres from their inside-out Klein-bottle personas.
Writing is propelled by drive. The propulsion of a “konstante kraft” (Lacan Seminar XI) this propulsion creates a jouissance as a somatic force on the psyche which works to tie the social-symbolic (the big ‘Other’) and the corporeal ego. Here the lost object – the object of desire – is left with no alternative but to press forward: it just goes as Lacan says, “without any perspective of ever ending the march or of reaching the goal.” In this sense the drive as jouissance is the essence of being in the doing but never arriving. It doesn’t provide calm, nor satiety because only driving is possible. Desire is not jouissance but instead jouissance is the push to keep on desiring. In 1964 Lacan said that the drive does not reach its object to culminate in satisfaction, to the contrary the drive permits no halting at any position attained. This insatiability of the drive is what makes it memorable and transgressive. As it moves through the historical, both phantasy and pleasure are blocks that serve to slow it down. An immersed dedication to an art or act of creativity forms a jouissance, for Hegel it results in a transcendence or a sublimation that transforms libidinal energies toward higher artistic or cultural realms.
The need, the reason, the push to write is guided by this drive. Words are merely a by-product, a Lacanian symptom, the concrete evidence of the journey, like the smoke wafting from a lit cigar, slowly taken in from lips to lungs. Where does drive originate from? Where is it born? In 2013, Bazan and Detandt published an article on the physiology of jouissance from a psychoanalytic perspective. This article is fascinating and well worth a read, it does however venture beyond the parameters of complexity set by the borromeanknocker. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818686/.
In 1915, Freud’s model of the drive was as an impetus to relieve tension, (disequilibrium arising due to a biological need or lack). Relief was seen to be achieved through internal alterations that restore tension by bodily stimulation or an expression of emotions: screaming, laughing, crying, movement that leads to relief (muscular, sexual, sensory). Bazan and Detandt draw attention to the person’s bodily experience and their past history of actions that lead to a compulsion to seek relief and attain pleasure in the tension release. Bazan and Detandt propose that “In Freud’s model of the drive pleasure is what results form the release of tension…while jouissance is the (benefit gained from) the motor tension underlying the action which was (once) adequate in bringing relief to the drive.” Their focus is on the use of the body, its mobilization to action. They quote from Marie (2004, p.27) who says “Jouissance … is very close to l’agieren” which is to act out, operate or perform. Jouissance becomes an action that previously led to satisfaction even though that satisfaction has become faded or even painful or detrimental. Freud (1895, p319, 326-27) outlined hallucinatory memory traces of previous satisfactions jumbled with suppressed mnemic images that surface and are made conscious and like dreams they mix with external perceptions. Our biochemistry, our subconscious, our drive, it eggs us on to repeat, to re-experience to revisit actions that just might lead to satisfaction but over time become part and parcel of who we are.
The compulsion to write is then, for some, a journey of jouissance, the act in which words are brought to the surface mixing up the now and the then. Like a stream oozing from a rock, creativity creates rivulets of new thought from old. It carves its neurological route, using well worn semantic webs with sparks where original connections link with antiquity. A journey once paved by pebbles, perhaps surrounded by grassy banks, ushering from its birth place, growing, spreading and disappearing from view. The ideas meld as an author’s labour of leaves, leaves its trace.
In writing thoughts and sensations are left behind as words flow. Lacan states in Seminar XX, 110/121, “Writing is a trace in which an effect of language can be read.” This trace is neither linear nor chronological. Meaning is reaped from the past into the now but the present is always in movement. The sensation of the trace burrows into the flesh fusing with the intellect. Derrida states, “This trace relates no less to what is called the future than what is called the past and it constitutes what is called the present by the very relation to what it is not.” This is Derridian différence: a differing and deferring of presence, or a continuous play of absence and presence. It is the epitome of representation in writing and image. The trace is in essence both the mark of the future and the past in a present moment which is neither. The trace is the “essence of Being” that haunts language (Derrida 1982, p.126).
We see, hear, feel and use all our senses as the essence of thought is transformed. Every meaning is communicated through signifiers. These may engage our senses in personal or universal meaning. As each signifier acts upon the body, new signifiers are unveiled in a signifying chain. So how much of the original idea is conveyed? To ‘mean’ anything, a signifier must presuppose a signified already and always outside it. This for Derrida is the “transcendental signified” which belongs to a universal realm of language. Its sense is suspended until it is brought to life alongside a chain of signifiers and meaning is made apparent along the way, (ch ch ch changes), although what is said and what is received may need clarification.
Turtle is understood when it is associated with related words to define it: interpreted as a slow-coach, a shy person, someone or something somehow reptilian, or perhaps a floppy necked jersey. Writing as a trace for Derrida is the “absence of the presence” a bricolage of weaved elements combining phoneme and grapheme that heads towards meaning, “whilst half of the sign is always not there and the another half not that.”
In the way of Barnard and Fink (2012 p.19), borromeanknocker endeavours to throw some Lacanian light upon “manifestations of a certain ‘cross-sightedness’ reading between the signifier and the letter, articulation and writing, and truth and being.” The body is sensitive to the effect of language as a Lacanian “echo in the body” its resonance is palpable, felt within the modalities of the senses. Whether words are received through the ears or eyes the signifiers and their chains pull on emotions provoking a reaction: humour and laughter, sadness and tears, nostalgia and reminiscence. Tastes and smells are evocative as they take the present and place it back in time. Before a sentence is completed signifiers can send the recipient off at a tangent where meaning is no longer universal but seeps out, escaping from a personal past.
The Lacanian relationship between the signifier and signified delves into an awakening of the unconscious where meaning is variable according to the surrounding structure. It is not as reciprocal as “two sides of a sheet of paper” as Saussure would have it. Saussure’s mutually interdependent relationship of the “sound pattern” where an “image acoustique” relates writing to speech for communicative transparency, or as Derrida (1976, 43) says for Saussure a “sign of a sign” is necessary but not sufficient. The name David Bowie doesn’t simply (re)conjure a static image of the artist. The signifier is the physical somatic form taken by the sign as it enters through the senses. Jakobson (1963b, 111; 1984b, 98) describes it as the external perceptible part of the sign. The memories evoked by the word Bowie may conjure a pungent smoky seventies concert hall, the laughter of particular people, tickets for events, heartfelt emotional ties related to decades past, or last weekend’s beers in the pub. Acts and objects have no intrinsic meaning until they are invested somatically in memory. Items “out there” become in-corporate “in here” as words spoken or printed on the page take their effect. A signifier without the signified is called by Lacan the “pure signifier” and this is what happens if the word Bowie or Midge Ure mean nothing to you? Lacan, (1955, 6:185) with reference to Freud’s indestructible unconscious, states:
“Every real signifier is as such a signifier that signifies nothing. The more the signifier signifies nothing, the more indestructible it is”.
Soler (2014, p.63) Discusses Lacan’s “pastiching” of James Joyce, how he “undermines orthography with dysorthography” Hissecroibeau is Il se croit beau – he thinks himself beautiful. Acoustically similar l’escabeau means stepladder. Stepladder creates connections in the mind and links with other Joycean references. It is left to the reader to dissect it for personal and Joycean meaning: smacking of a certain narcissism: climb up to me, find me in the heavens, look at me up here – looking at you down there. Soler goes on to suggest est-ce cas beau? Or is this case beautiful? Is the outer body our idea of an Adonis? Or es-ce cabot? Is it a mutt? A mongrel, a cross-breed with no pedigree. Lacan writes, S.K…. beau. He playfully reduces speech to phonemes, ES-K B-OE.
T h e S t e p L a d d e r ( e s c a b e a u ) a n d t h e S i n t h o m e Pierre-Gilles Guéguen
In my research for the borromeanknocker I later stumbled upon an article “The step ladder (escabeau) and the Sinthome” written by Pierre-Gilles Guéguen translated by Julia Richards. It is part of a flyer showing contributions toward the 10th congress of the world association of psychoanalysis in the 21st century entitled: the speaking body – on the unconscious.
Pierre-Gilles Guéguen draws our attention to Lacan’s uses of the Joycean metaphor of the step ladder. Our step ladder enables us to imagine our bodily selves, to revel in our projections of that ideal-I, but our lives are lived in the social world of “being” and our appearances are all representations contingent upon language. Here our focus is on the trace of words and the pleasure derived from certain deviancy, of deviations and derivations in discourse.
Unconscious knowledge imprisoned and repressed in language (langue/langage) is expressible and has a vehicle in writing and indeed in speech. In psychoanalysis trace from words uttered by the analysand can be pondered and re-assigned their signifiers.
In Seminar III, p.167 Lacan says:
“…the trace, the footprint in the sand, the sign about which Robinson Crusoe makes no mistake. Here sign and object (Crusoe) separate. The trace, in its negative aspect, draws the natural sign to a limit at which it becomes evanescent. The distinction between sign and object is quite clear here, since the trace is precisely what the object leaves behind once it has gone off somewhere else. Objectively there is no need for any subject to recognise a sign for it to be there – a trace exists even if there is nobody to look at it.”
The knock of the knot – Breast Cancer with a Lacanian Shape AngleCurve
The Real – Fear Intrigue Fortitude
Deride me not when I write sous rature! Part of my kick is the satisfaction achieved in the toying with language. Or even the loy of tanguage: tangle, wrangle, engage, joy, toy, employ. This chapter traverses the path between the lumpectomy and its clinical findings. The chapter examines jouissance and the Lacanian Symptom in a manner that endeavours to simplify their guises. It questions how much control each of us has over our own health. Could you rot an apple with your mind? The final paragraph situates the patient face to face with the oncologists’ verdict on a day when other distracting matters took the cancer pedal off the gas!
Derrida’s first indebtedness to Heidegger lies in his use of the notion of sous rature (‘under erasure’). To write ‘Under Erasure’ is to write a word, cross it out, and then print both word and deletion. Visually the original word may be read and understood alongside its replacement. Once it has been crossed out, it is barred, its relevance is questioned. It is erased but still shows evidence of a path once taken. How does what it meant before compare with its meaning now? Meaning can be inferred in a transference from the symbolic of the writer into the personal imaginary of the reader. The reader already has a mille-feuille of layered of meanings to wrangle with. How does writing “sous rature” add to the multitude of signifiers that vie for a priority of meaning?
AnglesCurvesStraights From Something to Something Else
Breast surgery leaves a woman with cuts and scars: period. We do not know what will become of us when this journey begins. Surgeons hope for the best outcome but healing is individual. As these marks heal, some rise and wheal, some turn into thin, flat, silver slivers, others redder, wider jaggedness. Under the skin the flesh has been torn. This seismic movement may leave lumps, bumps or oddly smooths – more straights than curves, or more bulges than straights. How our bodies are left will never be static, always evolving. Our states will never be still: our mornings different to our evenings and our hormoanal tides, wild or tamed will shift the balance.
Jouissance is both how we feel and react to our inner drive to enjoy ourselves. Jouissance is our individually chosen “carpe diem” how we choose to seize the day. In their chapter metapsychology: from body to history, Bazan and Detandt (2013) propose that jouissance is in the order of “agieren” or taking action. In this sense the pleasure is felt more strongly in the action leading to the seeking of an object of desire than actually obtaining that desired object. They suggest that jouissance is related to the release of motor tension that brings relief to the drive. While pleasure implies the consumption or attainment of an object (objet petit a) jouissance is in the use of the body.
How we deal with life, particularly within the time of an evolving cancer journey depends on our calling, our ego and how we choose to channel the release of our libidinal drives. The Lacanian symptom is the way in which we pursue our jouissance. The symptom may take the form of a character trait, manifested as being over tidy or untidy, controlling of others or being subservient. It may compell us to seek solitude or reacquaint with friends. Seek wide outdoor spaces or stick to homely routines. It may take an artistic form. Often anxiety and the libido transformed in crisis becomes the organizing principle of the jouissance of the artist or writer. Thus our mode of jouissance is the Lacanian symptom. Our particular chosen activity and our way of enjoying it will be repeated. This is because it gives us each, (as the human subject) a consistency. Our chosen “passion” is part of who we are. The Lacanian symptom is the visible trace of the particular modality for the subject’s jouissance. It is how the subject takes action to manage the distracting, disruptive, destructive, flotsam-jetsam of the unconscious. Jouissance is about how we silence, quieten or use-up our internal individualised libidinal chitter-chatter. It is how we tame this unconscious background noise of the mind, whose volume is often ten fold when faced with an uninterpretable Real: cancer.
Jouïs-sens (to hear meaning) Jouis-sens (to enjoy meaning)
The Real is the yet unsymbolised. It often looms up alongside a life changing event: a bereavement, an illness, a trauma, a cancer diagnosis. It often brings us in touch with our mortality and the ephemerality of life. This dance around the Real is an unconscious delving into our unconscious, stirring of our fears, fuelling and symbolising our imaginings, whilst relentlessly giving no respite. There is no escape from the Real. It catches us unawares from an angle seen awry. It is a sudden recognition of something unrecognisable. This misrecognition, a méconnaissance is where the subject becomes alienated in language, adrift beyond the symbolic, beyond expressible description. The impenetrable le mur du langage “wall of language” leaves the unnamed Real of the unconscious entrapped. The unnamed essence that is the unconscious will haunt us even more persistently in sleep. Sleep, where in our dreams anything goes. Where contradictions unify and nothing is prohibited because there is no “no” in our dreams. The unconscious is independent of language, a place where no meaning has been inscribed. In psychoanalysis however, unconscious meaning may move to the dominion of the preconscious, awaiting the intermediary of language. (J)ouïs is taken from ouïr to “hear” as the analyst listens. Progressively the analysis takes form through a matter of suturing and splicing until meaning is heard, jouïs-sens (to hear the sense or meaning). The desired psychoanalytic outcome being: Jouis-sens – I enjoy, I make sense – Enjoy-meant!
In Écrits, “Psychoanalysis and its Teachings” Lacan views the symptom as inscribed in a writing process. The symptom is a pure jouissance addressed to no-one because it is the manifestation of the way a subject enjoys (jouit) their unconscious, (Seminar “L’angoisse” 1962-63). Creative outlets during times of crises are undertaken for their own sake, if others can be appreciative then all well and good, but in the first instant they are a release, a way to channel the raw libidinal energies of the bodily drives. Creative outlets are a way to deal with the un-symbolised unconscious as the Real seeks a translation. The Real clamours to be symbolised with its “compelling and potentially horrifying alien material persistence” (Žižek 1997: 55–106; Braunstein 2003; Declercq 2004). It demands an outlet as it squeezes through the register of the Imaginary. Perhaps eventually it may succumb to a conscious translation in the more manageable symbolic realm. Although primarily the traumatic material of the Real is unsymbolised knowledge which nags submerged. It is latent, only occasionally rising (often with anxiety) as knots in our language and thought.
When Jean Hyppolite asks: “What use does the Symbolic have?” Lacan answers: “The Symbolic, the Imaginary and the Real are useful in giving its meaning to a particularly pure symbolic experience, that of analysis.” Since the symbolic dimension is the only dimension that cures, “The symbolic order is simultaneously non-being and insisting to be, that is what Freud has in mind when he talks about the death instinct as being what is most fundamental: a symbolic order in travail, in the process of coming, insisting in being realised.” Thus the “conquest of the symbolic order is essential for the human being to accede to a humanized structure of the real.” (S3 p.198).
Lacan was fond of saying “the Real is impossible,” impossible in that we cannot express it in language because the very entrance into language marks our irrevocable separation from the Real. Nevertheless in the event of acknowledging the materiality of our existence the Real overwhelms us. It forces a recognition that is perceived as traumatic as it punctures and threatens our very “reality” and drives us toward Lacan’s sense of jouissance.
Repetition and Joui-Sans
In Lacan’s later period he maintained that our methods of jouissance facilitate an achievement of libidinal-consistency by expressing-out our anxiety-evoking encounters with loss and lack. Through jouissantesque activities the holes that burrow into the pain of the Real are explored. During this (artistic, therapeutic or psychoanalytic exploration) unspeakable materials may begin to be brought to light symbolically, rather than being felt as psychogenic and enigmatic somatisations. The symptom is brought to the fore through repetition. In repetition we seek to recapture the first thrill of jouissance. Yet repetition is the curious link between the pleasure principle aka jouissance and the hidden mask of the death drive that is camouflaged behind this joy. Pleasure turns to displeasure as there is no recapturing the intensity of the very first instance of pleasure. There is no repeating the depths of ecstasy felt for the first creation, achievement or mastery. The death drive encroaches and its shadow looms larger in sync with the momentum of repetition. Pleasure turns to displeasure and eventually pain because repetition dilutes and slowly annuls the initial thrill into a consistency and evenness. There is no way to re-live the first hit of joy because everything after the first “buzz” is a reminder, a reminiscence, a substitute which never-quite has the real authenticity of the first time. If the pleasure endures, there is only so much pleasure one can take before it becomes painful pleasure. Thus jouissance is suffering, (S7, 184). Our jouissance mutates toward the frustration of an embittering joui-sans. For an interesting article see Bazan and Detandt (2013)http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818686/
Home after the lumpectomy Home, but wounded again. Just as my body had completely recovered from the biopsy the proper surgery was done already. For weeks the biopsy aftermath had continued to zap its zings of nerve healing pain. The pain wasn’t immediate but began a week after the intervention. It was a deep abrupt “high pitched” pain arriving with no warning. Now home after the lumpectomy I was facing another state of external and internal disrepair. It was a place of limbo with no health certainties. Thrown back into a strange day-to-day without yet having a medical verdict. Hemmed in by the hourly “what if” thoughts: If the cells had spread to the lymph my prognosis would alter. The incision was below the arm pit. It was hidden, covered by a large square of gauze and a wedge of waterproof bandage. Ablutions followed post surgery care instructions. It would withstand a soft daily shower but not a baptism of emersion. I tended it cautiously. A trickle of water poured like a delicate vintage. Whilst feeling more brazen with the healthy good-side, I was more todo-terrano, enjoying the normality for functional manhandling: relishing a one-sided hot shower and the rougher texture of a dry towel.
Exercises for post surgery breast healing I felt sad for my condemned pampered breast. Would it prove to be innocent or a traitorous accomplice harbouring the most evil malignancy? The bandage strips were strapped up tightly to give decent support all day and the maternity bra was helpful and comfortable to sleep in. It’s amazing how the body fixes itself. Every day it felt a little better. I continued to maintain the stretch exercises by using the routine sheet I’d been given to prevent stiffness. The first stages of limbering were standing poses. Reaching my arms up, stretching higher each day. The tissue tension was most noticed in the Winging It exercise. Placing hands behind the head, with elbows askew and gradually brought inwards to touch.Then the same but lying down: hands behind head and bringing elbows to touch, then lowering them to the floor. Ouchy, now that stretch was trickier! At first it was impossible to push my arms to the floor. The skin was taut and tight, but slowly over days it improved. Then a particular standing stretch I’d discovered (which wasn’t on the instruction sheet) was also incredibly hard: bringing the arm on the injured side across. Holding the right arm (of the injured side) out stretched to the right then bringing it ahead and then diagonally across the body to the left. What a tug to the back muscles that caused!
Comforting Accessories Sleeping was difficult. My dream idea was a mattress designed with a chest slot similar to the above. I didn’t go for this but would be interested in hearing of its efficacy. After the surgery my preferred position, sleeping face down, was on-hold indefinitely. To be pain-free the injured side needed to be maintained parallel. Not so easy to keep the breast aligned on top. It helped to prop a pillow along the side of my body adjacent to the breast, to keep it from sinking to the side. The parallel arm slightly elevated. I found a site with some interesting breast pillows but following surgery I didn’t find them useful. http://breastcancer.about.com/od/treatmentoptions/tp/comfort_pillows.htm
Power of Thought– Healing v Harming A ten day wait lay ahead. What would the outcome be? The ideal scenario would show clear margins with no lymph involvement. But thought power was not going to change the verdict. You can’t seriously wish yourself well or think yourself sick…can you? I tried not to let my mind wander through the consequences. But around this time there was an article that created a bit of a furore. It was about the power of positive versus negative thinking. Brow furrowed and lips pursed in thought. Can you rot an apple more quickly by throwing it a barrage of hateful thoughts. Well apparently so. Everyone would agree that you can’t wish yourself to win the lottery. You can’t really create a voodoo-like hex to wish ill on yourself or indeed others. Wishful thinking is surely as it sounds: wishful. A timely article indeed to show the power of scepticism and how a damaging mind-set supposedly causes actual bodily harm. http://thecharismamodel.com/the-big-apple-experiment-gallery/
Bewilderment – Be Wilder I Meant! So the “C” diagnosis is a long fall down. Hitting the ground takes longer than you may think, with some of us hanging on before falling further. The diagnosis leaves survivors in a minefield of bewilderment. Now this is a word for a little Lacanian mischief. A word that states it is “meant” to “be” “wilder”. In this wilderness one is left to roam, to be separated, estranged, isolated, from the logical sense and meaning of “the other”. In this wilderness the patient may forget the symbolism of what is said or read. Instead being left to tune in to the body, filtering-away the white-noise of the outside. Instead listening to an imaginary dialogue of a future yet to be lived. Pre-diagnosis leaves the mind to wander and wonder. The realm of the wandering leaves us wondering where the next trip wire may be.
Echoes of you’ll be fine, they’ll figure it out are reassurances from the “big Other” – hopeful sound bites used as part of the illness language schema. So I wait, impotent and expectant, silently numbing scepticisms of any half empty glass. How will one accept and cope if faced with a sorry verdict. It is my body. If it is rotten at its core it will still be my body. Things could still swing back to the knife. Further slices required if there weren’t clear margins. If the lymph were to be affected then all sorts of possibilities open in the road ahead. Iffing and butting are impossible to surpress and they help the psyche prepare.
Word and Action Ten days after the surgery the essential appointment arrived. My mind wasn’t actually tuned in. The admissions secretary assured us (I wasn’t alone) that my early appointment was not running late. My preoccupation was distracting. I needed to be seen to have the healing process checked. Beyond that it was all ce la vie. An automaton, I needed to leave. My eyes were darting to the time. The door opened punctually at 10am. How efficient would this be? Entering the clinical room, the dressings were removed, the red-rawness of the scar was positively appraised and the skin-tissues were left to support themselves. In preparation, my underwear seams had been cut away to leave room for the bare skin. All was repairing nicely. We had a train to catch. My mind was not on my situation. We had to leave this appointment and leggit to the station. We couldn’t miss the train and arrive late. A week after my lumpectomy operation, my step-sister had been ingressed into a hospice. She had barely arrived there before passing away from stage 4 breast cancer. Two years earlier her symptoms had been leg and back pains and her prognosis the most grim. My appointment was at ten and her funeral, fifty miles from London was four hours later. Dressed once again we were escorted to hear my verdict. What had the surgeon found? We jostled into a tiny room with three oncologists preparing to tell the news. Hear it and run was the voice in my head. It was good news. The best news: low grade, small area of cells (<15mm) clear margins and no sign of trespass to the lymph. I didn’t want to stay to negotiate my treatment. Deep inside, I knew that they would follow the clinical protocol. Even if I had questions the “treatment package” was set in stone. Right now I had to leave. Perhaps they’d expected a bit more of a battle from me or at least a barrage of my usual questions. My chair scraped the floor as I pushed back and arose to gather my coat. We must have cut a strange silhouette in our angular black funeral attire. We barely shook hands before pelting out into the street to pay our respects to someone who’d been dealt a harsher hand and was waiting for her final farewell.
The knock of the knot – Breast Cancer with Lacanian Angles
Drugged and Woosie in the Recovery Room, I’ve woken up. A good sign. My left arm making the blood pressure machine bleep. “You’re athletic” it came more as a statement than a question. I did warn them that I was fit. My pulse at rest dips below 45bpm. Oh hell. Had they brought me back from a close shave with the grim reaper!? Who could tell? Would the surgical team ever admit to such a thing. Had I expected to die? Pop my bucket, kick my clogs! Well there is always that outlier, that statistic! Of course it had crossed my mind. All that surgical intricacy and teamwork almost lost. Do near deaths even get recorded? My fingertips felt a little numb so it may have been a real possibility. I can wiggle my toes and fingers and what’s more I can see them move. No phantom effect here. But who cares, I’m here. I made it back, vital signs monitored and still wired up to the drip. This time with tramadul and perhaps some other opiate ingredients. It was ten to one. The second hand moved with a deliberately slow pace. The slurred tick or tock of a clock that has witnessed the imbibing of one too many sedatives. Just over the two hour surgery-time. Probably no working-hour for extra-dramatics, no window for a resuscitation, no time for a near death experience. They’d done their job and here was the result. I was awake. And they perhaps were at lunch. There was someone communicating. Someone muttering, murmuring. Was that me? Was I okay to go back to the ward? I needed the bathroom. A bed-pan. Fine how could anyone argue. Humiliation didn’t fit here. Just needed to pee. Oh what relief. Yikes the bed pan seemed a little shallow. I had drunk loads before the zero hour or nil by mouth curfew. It put my mind at rest. Didn’t need to worry about that again for a while. They took it away. Soon after I reawoke, back in “my” bay by the window, on the ward. The air was chill. Had I walked here or had they wheeled me back in? Drowsiness had won through again. Falling back into the hole of unconsciousness.
Running on pause/paws
“When can I start running again?” Ooo that question was of interest to me too. Hey who’s speaking? Who are you behind this fake curtained privacy? Do you run? I run. What surgery did they do to you? Ah a tonsillectomy. Not quite on the same page as me then. Breast surgery. Malignant cells. Yes. No I don’t know when I’ll be up to run again. We exchanged numbers when we discovered we were neighbours near-as-dammit. I lay back. Time flowed over me. The second hand was Daliesque in its inability to mark temporal change. Was I ready to leave? Soon. Soon.
Most of the morning patients had self dismissed. A sandwich was offered. Gratefully I chewed, mouth dry, tongue like a wet roll of flannel. Egg with a vinegar mayonnaise. Perhaps I could try the cheese and ham please. The buttery bread was the most pleasant part. I texted my survival to family and friends. Delirious messages. Not so groggy now my things were neatly back in the rucksack. Of the three bras I’d brought along I chose one for support and comfort. The roushed under arm elastic low on the thick surgical dressing. The bandaged area was without sensation beyond numb even. Nurses saw that I was ready to leave. I’d been here ten hours. A bag of pain medication and dosage instructions were explained. Can’t say that I was able to take-in that information. My significant other was waiting, time resumed the pace of the outside world and we headed home.
The knock of the knot – Breast Cancer with Lacanian Angles
Facing Magazine 2010 Again
Transported back to wait for the next step I soaked up my wholeness. More than me, I had additions. Semi-cyborg! A Seven of Nine with all her thoracic metal implants! I tucked the blankets around my knees again. Those old glossy magazines smiling, grinning knowingly at my side. A wide berth. Who would touch them? And who do I tell that their existence was rather abhorrent. The bustle of medical staff in and around the corridors. If those magazines could tell their tale. How many patients in the last five years? How much weight of patience and emotional if not physical pain was held in this corridor, contained here and seen awry by the existence of such old magazines. They’d survived the duration, not even dogeared. Or perhaps some kindly soul had just recently left these magazines as a good will gesture. But five years since they’d been published. How many millions of births and indeed deaths since then. How many graduations, retirements, parties, partings? How many therapeutic hands had grappled with a condemned cancerous breast. How many daily squirts of antibacterial gel? How many others have recoiled at the magazines from 2010?
Mama Mia – Mammary mia!
Almost immediately a new team member in yet another white coat led me into a small room with a lethal radioactive sign looming on its door. Mammogram time! This time to record the position of the wire which acts as the tumor marker. The wire localization is for the surgeon to use the wire as a guide to locate and remove the tumor. During surgery the wire will also be removed. Stripped above the waist the vertical contortion began. Thank goodness for the desensitized breast asleep with its heavy dose of local anaesthetic. Oblivious to the wire inside as I moved it around. The struggle that women of a certain cup size know only too well. A mammogram dance of breast, shoulders, chin, arms and moving the other breast away to stop its natural tendency to sit squarely adjacent to its injured twin like a sympathetic watchman. Oh yes you younger readers what joys arrive with middle age protocols. Scorned for moving my hand the radiologist bid me to stay still. Yet she was clearly relieved to see me remove the unwanted alright breast (the wrong breast not the wronged breast) from the picture-frame to come. The radiographer slipped behind her screen. She was the observer, no hands-on for her. Watch the birdie, say cheese.
A click click accompanied by a gasp of failure, irritation towards a failed irradiation. Of course the wire was so high up under the arm, it was out of shot. A new photo-session commenced. This time at a more appropriate sideways angle. Like a David Bailey model standing square, half naked in a surgical gown posing to the commands: chin high, shoulder back, stomach tensed, jaw relaxed. A tight vice like squeeze. Who knows what was happening inside, but the local anaesthetic was so recently administered that pain was not part of the experience. Permitted to sneak a peek I saw the three images. Two of which had captured the wire insertion.
Outside in the corridor the pile of magazines lay untouched. Possibly untouched over the course of five years. Me done and dusted I waited in the wings for Michael, my guardian. It was a cool forty minute wait. I eyed the smiling magazines, they smiled in return as I nestled into the blankets. Composed and trustful, awaiting the next step and the procedure that lay ahead, back there on the surgical ward.
Speed and dope
Busy Michael returned as my loyal escort at almost ten o’clock. No longer hugging my several accumulated blankets quite so tightly I was returned to the ward and my bed by the window in the female bay. I wanted to text home, to report the success of the wire-insertion. Amazed that the procedure was over. It was a bright October morning. Sunlight poured through the window. Seconds after sitting down there was no time to contemplate because my blood pressure needed to be taken. Next the cannula team approached. As I suspected my veins had retracted under my skin. Typically not to be found in my arms, never in my arms, not by hook nor crook nor to my surprise in my hands. Before I could react, the largest most muscular team-member swooped over my shoulder (across the side I’d been protecting) and grabbed my forearm. With both hands bearing down upon the thin flesh protecting my radius and ulna he explained that if he squeezed (which he did with much skill) the veins would most certainly pop up and indeed they did. With no more ado the needle was inside the vein and the cannula was expertly fixed to the back of my hand. Someone approached with a label for my rucksack and in the next moment I’d been received by the anaesthetist. Moments later there was a short walk to the surgical room. Yes there would be time for a final trip to the toilet, how relieving, I’d drunk so much water, in preparation, the midnight before. I found myself led into the adjacent room perched and on the medical bed slipping my arms out of the gown as instructed. There was still time. Time to be introduced to members of the team. I was in the ante-room and the anaesthetic was being attached. I was introduced to students, did I mind, no, how could I? When would the blue-dye be administered? Just before surgery, not to worry.
A sentinel lymph node biopsy (SLNB) is a procedure in which the sentinel lymph node is identified, removed and examined to determine whether cancer cells are present. Early yesterday morning the injection of radioactive liquid, or tracer, was administered. Once under anaesthetic the blue-dye is immediately injected into the breast and it adheres to the radioactive tracer to easily locate the sentinel lymph node. A sentinel lymph node is the first lymph node to which cancer cells are most likely to spread from the primary tumor.
The surgical team watch as the dye collects in the first lymph nodes. This process oflymph node mappingassists swift and accurate identification of the cells. The surgeon removes about 1 to 3 of these nodes and sends them to be analysed to see if they contain cancer cells. A negative SLNB result will suggest that the cancer has not spread to the nearby lymph nodes or on to other organs. A positive SLNB result indicates the contrary, that cancer is present in the sentinel lymph nodes and may also have spread to regional lymph nodes and possibly other organs. With this information the laboratory report will help the surgical team determine the stage of the cancer and the extent of disease within the body in order to develop an appropriate treatment plan.
Back in the room, my underwear was riding up. Could I wriggle it downward. I fidgeted, would it make any difference at all? Would that be the first thing I fixed when I awoke? It was busy in the room ahead, one wheeled out and me wheeled in. Doped, I shifted my head back. It was exactly half past ten.
The knock of the knot – Breast Cancer with Lacanian Angles
Queueing behind the curtain
Soon after our arrival the first batch of patient patients were called by name. Addressed by a woman in crocs hugging a clipboard and chewing a pen. Each already signed off to their fate. Permission slips of all possible legal outcomes acknowledged in ink. I agree to… How they moved: toddling off, a macabre scene in its sombre innocence, as they were led away behind their clinical tour guide. The morning sunlight edged forward casting tubules of fairy dust, as a caretaker rhythmically mopped. Then nothing: an ellipses, ripples on still water. Time in its own dimension of now and then. An anticipation of next and another beat of the heart. Ten minutes later “our” subset were called. A mirror image where they’d gone right, we were led left. Equally obedient, six men and six women. As a member of the latter set once inside we were separated again. Our bay was female. The ladies placed their bags upon their beds. Oh cosy inmates. Each bed, made into a cubicle by a thin curtain tracked by ceiling rails. I was empty handed.
Confidently or cluelessly or trustingly, I’d left my “just in case” rucksack in the waiting room with my dedicated personal waiter. Yes I’m very fortunate to have my significant other there awaiting – but the choices leading to what made us “us” are another rambling story of on-line intrigue, anonymity and perseverance. Did he feel the weight of the bag or the weight of the wait? The white coats granted me permission to return – to retrace those steps through heavy security doors. Several long prismatic corridors, sometimes with glaring blinking windows, other times gloomy claustrophobic burrows. Hey I’m back, I escaped the group. My nose twitched: clinical smells. The abandonned mop waited. The rucksack which included the cell phone was held aloft. A final “final kiss” and this Alice chose to start again. Or was I the rabbit? Or was there really any choice at all? Enjoy your jouissance!
Meeting Michael my Chaperone
The curtained bay was cold. A draught from the adjacent window. I watched as my legs took refuge under the blanket provided. Automaton. Self preservation. A nurse came by to take blood pressure and I asked if I was going to have the blue-dye injection or the wire insertion. Blinking I knew the protocol by heart, in theory at least. Ah yes she said, yes, Michael will be here shortly to escort you. I had time to locate the loo and then meet my anaesthetist (another tall white coat) and then Michael arrived, flying in from a previous quest. I imagined him as an invincible Icarus sweeping down valiantly as the plot twists in a medical dystopian version of Brazil.
In a jot we’d left River View and had entered the specialised breast clinic zone. Michael said to wait. He’d be back. So here I waited. Waiting again but that was fine. It was part of the conveyer-belt process: not too fast. I did what I was told. No need to think. At 8:40 I was spotted and given another blanket. As I sat I fed it between my knees. Me myself and I. I studied the corridor. There on the side table lay magazines. I never had been a fan of those glossies out-of-place in a clinical world. So much for anti-bacterial gel when some of those magazines obscenely revealed their date of issue as being five years previously. Five years. The golden aspiration of those who hope to be survivors or in remission after this bleak diagnosis. Those magazines ensconced in their own timeless gasp of horror.
Rabbit in the wire
Led to the ultrasound and wire insertion room. Upon the surgical couch they discussed how I should lay. The cancer being situated high up, situated in an almost under arm area of breast tissue. This meant that lying flat was not possible. How can they view the eleven o’clock flesh? Those of you who understand or have observed the behaviour of the larger breast will know that once prone they don’t sit pert and neat, aloft on the chest. They relax out and downwards sinking with gravity into the arm pit. They sank and took eleven o’clock along with them, daliesque. As my accused breast sank, so the clinician realised a sideways stance would be the only way. Wriggled into a “recovery” type position my face was still able to glance behind. The ultrasound screen was in view. I wasn’t going to turn into a pillar of salt…frozen in time, that would be too easy an end. This adventure required a willing participation in the suffering ahead. But at least I had a front row seat to view the performance. Let’s repeat: Enjoy your jouissance!
With plenty of reassurance the area was numbed. A local anaesthetic needle glinted and was applied around the areola. Fortunately I’d been quick to ask exactly where that “sharp” was going in. This was déjàvue, I was here only yesterday and I’d read the blogs. I knew the lesson and this lessened the shock. Sharp scratch and it stung like a bee. For those who need details of the level of pain: the depth reached by the needle filled anaesthetic was barely felt, before even more anaesthetic was introduced. The area was numbed, comfortably numb and then came the posturing for the wire. Compliant I was shifted leg and buttock. Next the re-posturing of the breast. The professional with her hands-on-job to move mountains. Like Muhammed if that mountain didn’t come to her she would grasp “it” with more vigor. The guilty “it” that numb part of myself that had betrayed me and led me to here. That apologetic breast which so carelessly, innocently, flaunted cleavage on the beach less than only a month ago. Placing the wire in the flesh of course required some manhandling of the floppity yet fibrous tissues. Manhandle is that an outdated term? Handled like a man, by a woman? Floppity and yet not so floppity. This is dense tissue we’re dealing with here. A lollipop figure. This is tissue with a mind of its own. Tissue that fills tensely according to the hormonal tides. The hands on approach with a push-pull pressure increased to extract the needle after the wire was in place. The experts apologised for their exertion. Almost straddling my body and heave-ho! My, my that was a struggle to retrieve. In my googling I’d already read about this possibility. The shared experience put me at ease. It was a physical effort to achieve and retract but now with the wire in place the needle was out. Pretty painless. The ends of the wire were flattened and taped across my skin. A brooch but not one of valor. I was the receptacle. I contained the treasure, I was the x that marks the spot. I was the prize ready for the next monochrome photo shoot. I didn’t pay much attention to the what, nor the why. No bravery just obedience.
The knock of the knot – Breast Cancer with Lacanian Angles
No Universal Reality
We arrived on the day of surgery, October 8th at 7:30, pretty much on the dot. Dot dot dash dash, yes it seemed a bit of a dash but no elaborate preparations were made. The appointment was for a “speedy” out-patients operation so no toothbrush, only my cell phone and a choice of after-op boneless non-scaffolded underwears. Despite doubting their efficacy they were purchased precisely for their purpose and weren’t that easy to hunt down. Bravisimo was the chosen retailer for obvious reasons. Although there is still little out there informing about fit and comfort for pre-op purchasing. In September Stella McCartney, whose mother passed away from breast cancer in 1998, launched her “Louise Listening Bra” sizes S/M.
Quite a snazzy front zip fastening mastectomy compression bra, the proceeds from which will help benefit the Hello Beautiful Foundation. After much deliberation I chose a 32G maternity model the Royce Ava Bra (1154) that promised to accommodate my post lumpectomy breast. Without underwires it had a release catch (for breast feeding) but this seemed appropriate to relieve possible pain from pressure along the top of the chest and to give space for the surgical
gauze. The second design I preferred had a padded shell design. The cup was scaffolded to enable the breast to nestle in supported elevation and the side wires were set back more laterally against the ribs. Both of these bras needed customising with a scissor snip to cut away material under the arm. This was to avoid any clash and rub of stitching both animal, mine post surgery and mineral, the hemmed elasticated zigger zagger fabric in the underarm design.
Only a week ago I’d optimistically booked a batch of five yoga classes. Shockingly I managed just three on my “old-self” schedule: Wednesday and Saturday were part of my old-normality but the night before my hospitalisation the call to yoga was just irrelevant. So, essentially the guru yoga instructor is still in the dark as to the gravity of my seemingly casual absenteeism. This “mind before body” pre-op karmic choice, brings me one session closer to losing my toned arms and fitness. So instead of the chaturanga and chanting, the evening before the morning after involved a nice supper, easy chillax and a good grateful sleep. A clinging to just being. I’ve always, since birth, slept on my front so this too was a last chance to retire freely bellydown. A last sleep without pain. The last chance to be me before an unknown “x” that marks the spot. Nope, not even a pre-hospital hair appt. Neither preparation of an over night bag. All optimistic details, swamped out by just sucking in the last hours of normality, my normality…because is there ever a universal reality?
Zero Hour Arrives
The morning arrives and the taxi has little traffic to navigate. It all seems so ridiculously early. Up and active far earlier than a work day. Our timing was impeccable and we sat. Sitting in public. Sitting in the waiting room. Waiting to begin. Waiting as a pause. But isn’t sitting usually about waiting? Sitting involves anticipating, feeling the time, being “immersed in” the moment, whether it be travelling from here to there, driving or being driven, or taking in the time: sitting to relax, sitting back embraced by the hands of time, engulfed in the lap of time, gazing into the watch-face. Using the minutes to breathe, to be, to pause. Sitting as one waits: to eat, digest, or to hear the other person who sits and shares that time with you. (If you are, of course, fortunate to have comfortable company). A companion to weigh the time with. Oh heavy hour. Be light with me.
Sitting, waiting: it’s actually unlike me not to make eye contact with others, but looking here into the eyes of those who reflected the same situation as me, looking at them seemed so inappropriate. An intimacy shared in a moment seared and pierced by the obscene audacity of gaze, of daring to look them in the eye. Risking seeing myself, my fears, my doubts, mirrored back. Stepping in, making that advance, that cut in their reality, invading the moment of the other. I didn’t look. The power of the “gaze” and the gaze-returned. The gaze of the other freezing us in time. Seeing myself perhaps as another rabbit willingly waiting to see where this road will lead. Not yet trapped in a path of no return but given hope to cross and continue. Let’s face those lights, it’s not bravery, but a combination of ignorance and trust. A faith in science. A belief in statistics. Each person waiting was mentally and emotionally preparing for a scalpel that could prove to save their life. In the headlights, the footlights, the theatrical light, waiting for the curtain to move and for their newly assigned role to begin.