Chronic Disease, Empathy and Surly Traffic Cops

Chronic Disease, Empathy and Surly Traffic Cops
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"Don't take anything personally," Don Miguel Ruiz advises us in The Four Agreements, a memorable guide to Toltec philosophy. He gives one good reason:

All people live in their own dream, in their own mind; they are in a completely different world from the one we live in ... Even when a situation seems so personal, even if others insult you directly, it has nothing to do with you. What they say, what they do, and the opinions they give are according to the agreements they have in their own minds...

It's hard not to take it personally when other people are surly or otherwise unpleasant. But I need that ability in order to live and work in New York City, which sometimes seems like the international capital of casual crankiness and bad moods. Fortunately, I have been given a gift that makes it somewhat easier: my chronic disease, diabetes.

Don Ruiz is a wise man, but he missed something important about people. They say and do things not only because of the "dreams" -- and words, and memories -- thrumming in their minds. Their behavior is also prompted by what is happening in their bodies at any given moment. In fact, the dreams, words and memories thrumming in their minds are shaped, at least in part, by their bodies -- and not just the "thinking" parts of their brains, but also their glands, organs, lymph nodes, bones, etc.

Even though it's obvious that our own bodies affect our moods, it is easy to forget that this happens to other people, because we are lost in our dreams. So I try to use my diabetes to help me remember. Low blood sugar, for example, can make me cranky, silly, depressed or irrational -- or all four. High blood sugar sometimes makes me lethargic and inattentive.

It was useful to keep this in mind two weeks ago when a traffic cop wouldn't even respond or look at me while I complained about a ticket she had slapped on my windshield. And when a co-worker didn't invite me to a meeting I wanted to attend. And when a man on a sidewalk growled at me after I'd nudged his elbow as I walked past. And when a friend wrote something needlessly snide and cruel in a private Facebook message. What often goes on inside of me triggered questions about what might have been going on inside of them. Was it seasonal affective disorder? Faulty thyroid? Upset stomach from bad shiskabob? Pre-diabetes? Something much worse, something horrible?

Spend enough time poking around Hormones and Behavior, the official journal of the Society for Behavioral Endocrinology, and you won't take anything personally, because you will begin to think that there is a hormone responsible for every action and emotion in sentient beings. There is much more to this than the obvious ones, like testosterone or estrogen. Just read the titles: "Oxytocin and social affiliation in humans," "The relation between gaze aversion and cortisol reactivity in middle childhood," and "Thyroid hormones regulate anxiety in the male mouse."

Endocrinologists are piecing together a very small piece of the puzzle. There are also neuroscientists who believe the notion that we have any control over our own behavior, or any free will, is a myth. According to them, that traffic cop was a biochemical puppet, everything she thought and did was pre-ordained, bubbling up into her awareness after neurons crackled and computed, after hormones and neurotransmitters flooded cell receptors.

Many brain researchers and other experts on cognition disagree with this premise, as noted here and here. But everyone who studies the brain for a living seems to think that the decisions we make are based mainly on processes happening below the surface, and our conscious minds -- i.e., our wills -- play a very minor role at best. It's as if our conscious minds are second chair violists in a very large orchestra, but we don't hear -- and aren't aware -- of the other instruments that are playing the complex music of daily life. That idea can be oddly comforting when other people are behaving badly. It doesn't absolve them of responsibility for acting like creeps, but they don't have as much control over themselves as is commonly assumed -- maybe they're not so bad, after all.

It is easy for people with diabetes -- or Crohn's disease, or cancer, or rheumatoid arthritis, or other any other chronic condition -- to get frustrated with bodies that sometimes capture and control us, and even hold us hostage. Lately, I have been lurking -- and sometimes participating -- in chat rooms and blogs where chronics congregate. There is a lot of back and forth about the impact of specific afflictions on moods and behaviors. It is wonderful that social media allow people to candidly articulate how physical conditions provoke anguish, depression and terror and, if they can, to suggest antidotes. But I believe it is also important to remember that we are not alone, everyone on the planet is controlled and sometimes held hostage by their bodies. A screwed-up metabolism and even debilitating disease can be gateways to patience, and to empathy for everyone, especially those who try to push our buttons and get under our skin.

Originally published in The Insulin Chronicles.

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