Hell-Bent (43 page)

Part III: Not Dead Yet!

“If we take man as he really is, we make him worse. But if we overestimate him …”:
Viktor Frankl, “Man’s Search for Meaning,”
lecture,
Toronto, 1972.

“The English word
pain
comes to us from Poena, a dominatrix goddess responsible for vengeance and atonement. …”
This section on pain would have been impossible to write without access to the following excellent work by: Patrick Wall (
Pain: The Science of Suffering,
New York: Columbia University Press, 2000); Frank Vertosick Jr. (
Why We Hurt: The Natural History of Pain.
Orlando: Harcourt Press, 2000); V. S. Ramachandran (
Phantoms in the Brain: Probing the Mysteries of the Human Mind,
New York: HarperCollins, 1998); Norman Doidge (
The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science,
New York: Penguin, 2007); Richard Restak (
The Modular Brain,
New York: Touchstone Press, 1995); Melanie Thernstrom (
The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering,
New York: Farrar, Straus, Giroux, 2010). Impossible not to add that much of my curiosity about these interior workings of pain was sparked by a wonderful article read over ten years ago by Atul Gwande (“The Pain Perplex,”
The New Yorker,
September 1998) that I could not get out of my brain.

“C. S. Lewis called it ‘God’s megaphone’ ”:
C. S. Lewis,
The Problem of Pain,
New York: HarperOne, 2001.

“Listen to neurosurgeon Frank Vertosick Jr. talk about pain. …”
Vertosick Jr.,
Why We Hurt: The Natural History of Pain,
2007.

“Writing in 1664, Descartes encapsulated what, for many of us, still feels like an accurate explanation of physical pain. …”:
Rene Descartes,
Treatise of Man,
trans., Thomas Steele Hall, New York: Prometheus Books, 1972.

“In experiments where subjects were lucky enough to self-administer pain …”:
Jeffery Dolce, Daniel Doleys, James Raczynski, John Lossie, Lane Poole, and Melanie Smith, “The role of self-efficacy expectations in the prediction of pain tolerance,”
Pain,
1986.

“Consider, for example, the fifty-two-year-old machine shop foreman cited by Ronald Melzack and Patrick David Wall. …”:
Wall,
Pain: The Science of Suffering,
2000.

“This was the experience of Dr. Henry Beecher during World War II. …”:
Mark Best and Duncan Neuhauser, “Henry K Beecher: pain, belief and truth at the bedside. The powerful placebo, ethical researcher and anaesthesia safety,”
Quality and Safety in Health Care,
2010.

“Feeling only slight pain at the sight of their massive wounds …”:
For an extreme modern example, after his 1981 shooting, Ronald Reagan was completely unaware he had been shot through the chest, until he got to the hospital and started coughing up blood from a punctured lung. “I had never been shot before, except in the movies,” he said. “Then you always have to act hurt.”

“The new theory, known as the gate control theory …”:
Patrick Wall and Ronald Melzack,
Textbook of Pain,
New York: Churchill Livingstone Press, 2005; Wall,
Pain: The Science of Suffering
, 2000.

“Factors such as emotions, memories, beliefs, mental suggestions are all channeled to the checkpoint, mediating our experience of pain. …”:
Wall,
Pain: The Science of Suffering,
2000; Ronald Melzack and Patrick Wall,
The Challenge of Pain,
New York: Penguin, 2004; Fabrizio Benedetti,
Placebo Effects: Understanding the Mechanisms in Health and Disease,
Oxford: Oxford University Press, 2009.

“Finally and most important—actually overthrowing the gate control theory itself—researchers discovered there are pains that exist
only
in the brain. Phantoms …”:
Wall,
Pain: The Science of Suffering,
2000; Ramachandran,
Phantoms in the Brain: Probing the Mysteries of the Human Mind,
1998.

“One of the extremely helpful qualities of neural networks is they get stronger the more often they are activated. …”:
Doidge,
The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science,
2007.

“Of the forty-six members who completed the study, only three decided to continue with the surgery. …”:
B. Nelson, D. Carpenter, T. Dreisinger, M. Mitchell, C. Kelly, and J. Wegner, “Can Spinal Surgery Be Prevented by Aggressive Strengthening Exercises? A Prospective Study of Cervical and Lumbar Patients,”
Archives of Physical Medicine and Rehabilitation,
1999. For more information, see also D. Carpenter and B. Nelson, “Low Back Strengthening for the Prevention and Treatment of Low Back Pain,”
Medicine and Science in Sports and Exercise,
1999; and S. Leggett, V. Mooney, L. Matheson, B. Nelson, T. Dresisinger, J. Van Zytveid, “Restorative Exercise for Clinical Lower Back Pain,”
Spine,
1999.

“But that was because the Physicians Neck & Back Clinic in Minnesota was pioneering a new type of rehab. …”:
Although Dr. Nelson was a successful orthopedic surgeon, trained at the University of Minnesota, one of the best residencies in the country for orthopedic surgery, few of his ideas on back care came from his training. “Back then, if we didn’t operate on someone, we told them to rest,” he tells me. “We had some of the most famous spine surgeons in the country, but the actual benefits to patients were extremely limited. … Everything I know about exercise physiology comes from one man, Arthur Jones.” Jones, an old-fashioned multimillionaire eccentric of the best kind, no doubt worthy of an entire book himself, was a self-taught polymath,
best known to the general public as the man who pushed the precise alignments of Nautilus machines into gyms across America. As a trainer, Jones was a solid thirty years ahead of his time, recommending exercise until failure (“bicep curls until you puke”) at a time when conventional wisdom had elite weight lifters working slowly but steadily in the gym for seven hours a day. He used his techniques to produce staggering results (see his pupil, Casey Viator, putting on a whopping sixty-three pounds of muscle in twenty-eight days without steroids) and became a force in the professional bodybuilding world. By the time Dr. Nelson met him, Arthur Jones was in the midst of a restless retirement living off his Nautilus fortune in Florida, attempting to grow the world’s biggest alligator, and engaging in a self-described project to revolutionize back care in America. Jones had become steadily disgusted with the current system, which he believed lucratively rewarded doctors for offering options that produced little relief for patients and then trapping patients into accepting those options by offering higher disability payments if they accepted them. When he heard that Dr. Nelson was a young orthopedic surgeon open to hearing unorthodox ideas, he flew him on a private plane to his retirement compound and proceeded to pitch a thoroughly researched case for back-pain rehab based on strength training. Dr. Nelson left shaken but impressed. Their relationship would grow over the years, with many of the rehab techniques of the Physicians Back & Neck Clinic growing directly out of the collaboration. Fascinating also to learn that Arthur Jones was another socially coarse perfectionist, who slept little and possessed a totally domineering self-confidence and truckloads of charisma, a man who was seared with a conviction that he was giving something to the world, and constantly insecurely pitching himself to make up for the fact that his formal education stopped at the eighth grade, a man prone to calling Dr. Nelson late into the night to talk exuberantly for hours and hours, much to the exasperation of Dr. Nelson’s wife.

“Instead of pain being some exceptional outlier … all perception operates within the anti-Cartesian principles of pain and the gate control theory. …”:
Ramachandran,
Phantoms in the Brain: Probing the Mysteries of the Human Mind,
1998; Ramachandran,
The Tell-Tale Brain: Unlocking the Mystery of Human Nature,
New York: Random House, 2011.

“Our consciousness only an interpretation, minimally corresponding to the stimulus external to our brains. …”:
At the far extreme, we have patients with a type of multiple personality disorder that extends beyond personality into the physiological: where two or more “people” reside in the same brain, each having slightly different vital signs, allergies, vision (one might be nearsighted, the other have 20/20 vision), and hormonal profiles. Ramachandran,
Phantoms in the Brain: Probing the Mysteries of the Human Mind,
1998; Ramachandran,
The Tell-Tale Brain: Unlocking the Mystery of Human Nature,
2011.

“Neuroscientist V. S. Ramachandran talks about the essential dilemma this dichotomy produces in his patients. …”:
Ramachandran,
The Tell-Tale Brain: Unlocking the Mystery of Human Nature,
2011.

“Jill Bolte Taylor took a decidedly less pleasurable route to this same realization … In her book,
Stroke of Insight
…”:
Jill Bolte Taylor,
My Stroke of Insight: A Brain Scientist’s Personal Journey,
New York: Plume, 2009.

“The Human Physiology Department of the University of Oregon published the first scientific paper demonstrating that the benefits of heat acclimation …”:
Santiago Lorenzo, John Halliwill, Michael Sawka, and Christopher Minson, “Heat Acclimation Improves Exercise Performance,”
Journal of Applied Physiology,
August 2010.

Part IV: Like Kool-Aid for Water

“ ‘We talked of everything,’ he said, quite transported at the recollection. …”:
Joseph Conrad,
Heart of Darkness and the Congo Diary,
New York: Penguin Classics, 2007.

“That it was none other than Bhagwan Shri Rajneesh, the proudly deviant, ultimately monstrous force of twentieth-century charismatic wisdom, who famously decreed that ‘authenticity is morality’ …”:
Bhagwan Rajneesh,
Philosophia Perennis,
Rajneeshpuram: Osho International Foundation, 1981.

“That he does not tolerate the color green in his presence …”:
When asked about the interdiction on green, Bikram is clear: “Okay. It’s superstition. India has millions of superstitions. If the slipper by the door is upside, things go bad. … For my guru, green was superstition, but it was also personal.” In 1942, Bishnu Ghosh’s son Krishna was trapped in a tent and burnt alive when a fireworks demonstration went awry. He had last been seen wearing a green shirt, and the guru passed down the tradition of forbidding green on his disciples.

“And his tea has been brewed. …”:
A lemon, ginger, honey infusion into hot water, no caffeine, designed to soothe the throat of a professional speaker, who may or may not be about to launch into a Castro-like marathon lecture.

“Tonight’s lecture is on the art of teaching. …”:
As I hope I have conveyed in the text, the lectures at Teacher Training were extremely discursive, and as a participant, my brain was often fairly frayed. All quotes are directly from my transcribed notes, and the themes are ones Bikram referred to repeatedly. And while I am certain meaning is conveyed as Bikram intended it, the exact order of the sentences—often reconstructed from a jumble of page-crawling lines in my notebook—might be shuffled throughout this section.

“That he wants to show us a movie. A Bollywood movie!”:
While some
of these movies are yoga related, most are not. By far the most memorable is a serialized version of the great Indian epic the
Mahabarata
that is so implausibly low budget that I get a contact high every time we hear the opening soundtrack. In this
Mahabarata,
every prop is made of cardboard, every special effect is recycled in at least two or three different scenes, the sound mixing swings wildly with scene changes, beards disappear and reappear during reaction shots, and all weapons clash with the same weird clanging your first-generation computer made when you would press too many keys at the same time. It is interesting to note that Bikram loves this serialized
Mahabarata
with zero irony. He leans into the screen and cackles into his headset microphone, often pausing it to explain the unrelated moments of his life back in India he associates with watching the show as a young man.

“The bushes outside the tent after class always have a least a few people weeping into them. …”:
The more modern science looks at sweating, the less evidence it finds for detox. That is just not the way most chemicals exit our bodies. However, the heat-induced suffering in a Bikram class—the sustained effort, the freaky acceleration of heartbeat that comes despite standing stock-still, the fear of pressing up against a physical edge—definitely produces an emotional release. This emotional detox is very real and occurs as kinetic memories—memories stored in association with certain movements or physiological sensations—rise to the surface during the controlled environment of a class. The repeated nature of the series, the safety of the entirely bland surroundings, the anonymity of strangers, the intimacy of the mirror, and the repeatedly psychotically confident assurances of a teacher insisting that everything you experience is not just normal but evidence that you are doing things correctly, provides an ideal framework to work through trauma. Eventually, as with all sensations in the yoga room, you become witness to all that you don’t control: sensations from the deep past rise up and wash over your cortex, your eyes in the mirror remain, and unlike whatever heavy metals may or may not be floating through your bloodstream, there is the possibility of true release.