From  FUNNEL to tunnel

Maître Jérôme’s easygoing life as a high school math teacher came to a screeching halt with resounding thud and sudden burst. A series of events beyond his control were troubling his routine. First, he began to have a numbing sensation from his right hip going down his leg. He ignored it for quite some time, and it has progressed to constant pain and was affecting his quality of life in more ways than one.

He normally walked at a brisk pace to and from work for a total of three miles. That was the only physical activity he was willing to partake in. With great consternation, he discovered when he went to see his physician that he had a long nerve, his sciatic, pinched. “Your weight is not helping matters,” his doctor added. Any reference to his ever-expanding abdominal girth approached a sensitive territory. He has been hearing ceaselessly from his mom and his friends about the surprising turn of his body shape, from a lean one a decade ago when he was in his twenties to a portly size. The truth of the matter was his new love affair with food. Adding insult to misery, his new girlfriend asked for nothing more than let him indulge, in the best role of an enabler.

She was a great cook by our standards. She enjoyed both the ability of preparing the meals and the pleasure of savoring them. Needless to say, Maître Jérôme didn’t care to hear about changing his eating habits.

“What can you do to help me doc?”

“Let’s try these samples.” He gave him Tramadol, “You can take them up till three times a day as needed to help with the back discomfort. However physical therapy should also help and definitely shedding some of the extra poundage would help. Swimming has been known to give some relief.”

What registered was to take Tramadol up to 3 per day. Everything else didn’t reach his ears. The samples the doctor had given him were a lifesaver. He had a somewhat restless but pain-free first night. By the second night, his troubles really amplified, in a pattern of intolerable nights that would last a whole week.  The first one really spooked him. He woke up from his sleep drenched in sweats, with fright, disarray, and even panic in the throes of a nightmare, a most unusual event in his life.  The events of the dream were so vivid that he began to shiver. As often happens in such an occasion, the storyline and its rhythm followed their own path in space and time. He was an observer looking into a documentary about himself, like his biopic, all in such real time sequence and with such verisimilitude to give him goose bumps by just watching.

The first scene of the documentary was a narration. It began at church on a Sunday morning for the 8 a.m. mass. His seat was empty. The one he usually occupied in the first row on the right facing the apse. A narrator’s voice came to explain citizens’ concern about this conspicuous absence. “Maître Jérôme never misses mass, be it the 5 a.m. during weekdays or the 8 a.m. on Sundays. He was such a fixture that no one dared to occupy his seat.” The narrator continued, “His absence from service was as strong a sign of a bad omen as there could be. Everyone knew that nothing good would stem from Lionel coming back to town. A school dropout and a vagabond for a good part of his adolescent life, he had left town a few years ago and rumors had him enrolled in the dreaded security force of the local congressman and he had developed the reputation of a thug officially sanctioned. That security force was in essence an armed gang, and the new paradigm was a collection of power-hungry grifters, in public offices doubling as warlords. Lionel had the plum position as head of the local henchmen. As soon as he had set foot in town, he made the following comment, ‘A new sheriff is in charge, and I am gonna shake things up.”’

Once awake, he started thinking about the previous scene. From his perspective, such a menace sounded like a real threat and not an imaginary possibility. He felt like a vise pressing against his chest and his life slowly winding down like an hourglass. That scenario alternated with another image of his life being effaced in a swift manner, in the blink of an eye. What remained fixed was an odd sense of a bad omen and a swelling premonitory warning of bad days to come. This was bad enough. More was to come.

The next night, he saw Lionel in his youth living as a vagrant, a kokorat, after flunking out of school. With his comrades, he was bitterly complaining about the grudge he held against Maître Jérôme who gave him an F for the math class due to a poor performance in the final exam. “How the hell does solving an equation put bread on my table when I am hungry? School curriculum makes no sense. Well-fed folks come up with all this stuff just to make you suffer and humiliate you. What do I know about an unknown to be found? I ain’t looking for no unknown. I want a known quantity, like money, to survive. I like the smell of it, especially a crisp new bill. A wad of cash opens a lot of doors.  Yes, money is like a devil but the kind that everybody loves.” This type of volley was just the introduction. His ranting would go on and on.

“I can’t stand the so-called smart set. They seem to always come up with the right answer that the teacher asks. How the hell do they know this stuff?” The narrating voice chimed in, “His invectives against the educational system, and by extension its enablers, blunt as they were, were stroking a raw nerve and even had the sheen of a well-thought-out analysis. The searing scene of his comrades clapping in support of Lionel’s comments in the background stung Maître Jérôme.

Maître Jérôme had to rake his brain to remember this particular individual since so many youngsters were falling by the wayside, a tragedy in of itself. As dedicated as he was to teaching, it dawned on him that he hadn’t considered a failing student’s point of view. He just assumed that the student should understand the matter at hand and if there was some confusion, it behooved him or her to ask the teacher for help. Nonetheless the idea of the irrelevance of math in real-life was so warped as to stun him. Math concepts came so easy to him that he failed to imagine that it could be otherwise for the average person. He decided from now on to inquire about this reality by talking to poorly performing students and figure out how to enhance his teaching technique. At least something good could come out of this unpleasant side effect of the medication.

The following night, another disturbing scene returned.  The narration resumed, “Lionel and his goons paid a visit to Maître Jérôme at his house the night before Sunday’s mass.” This was followed by actual images as they ransacked it and gave him a licking, leaving him with bruises. Maître Jérôme watched himself speak, “What have I ever done to you to deserve this?” he asked Lionel. Instead of an answer, Lionel slapped him hard, splitting his lip. “You intellectuals always think you know everything, always looking down on folks, that’ll teach you a lesson, teacher,” Lionel offered as food for thought. “‘Looking down on folks,’ resonated long after the physical abuse, a rebuke with a sting more painful than the searing throb of the blows,” the narrator mentioned.  Maître Jérôme was in the position of watching the actions and listening to a narrator speaking his mind as he said, “Maître Jérôme is the last person to ‘look down on folks.’ He had gotten in trouble for cozying up with the less fortunate. He took the accusation as a moral letdown, an indictment of the first order for he always wanted to fight for the cause of the have-nots.”

That last sentence brought the viewing to its end, and he awoke in that between and betwixt state, not knowing if this was real, made up or a prediction of events to come. As his mind cleared up, the uncertainty remained. An uncertainty about the presence of an omen, an epiphany, disguised as a bad dream. The possibility of an omen leading to an epiphany was just a real possibility. Will he be a victim, or will he come out of this whole ordeal a better man?

Thugs coming back to take revenge for real or imagined slights were unfortunately a common event, enough to become a matter of concern during his short walks to the church or his daily treks on the way to work. This type of stress reeks of a byproduct of opening a Pandora box. Once removed from its bottle, this genie won’t go back in. From now on, the concern about a ruffian on the lookout for his whereabouts always became a concern in the back of his mind. Pinched nerve, nightmares, personal insecurity in a linear progression of a troika of demons that ensconced themselves in his private space, snuffing the pleasure out of his tranquil life. At any given moment, any of the demons could reign as the first among equals to instill misery. Like a play about villains jockeying for position for leadership in wickedness.

Maître Jérôme had enough common sense to deduct that the new medication, Tramadol, was the culprit. It did help the back pain, but the recurrent nightmares were taking a toll on him. Real-life choices were his to make. Stop taking the med or not. Cut back on his meals’ portion or not. The elephant in the room, his overweight, long ignored, merited some long-needed attention. It occurred to him that his failing efforts at controlling his appetite and weight gain were no different than the lot of failing students. Foibles are part of human nature. What ought to be and what is, more often than not, don’t jibe. He knew that the likelihood of reducing the size of his servings was low. He didn’t want to fool himself.  His food addiction was too strong, and he lacked the discipline to start a regimen of regular exercise.

Imagine a teacher who is preaching students to develop the discipline to learn by studying and steadfastly do their homework, yet has no willpower to practice what he was preaching in his own life. This was a dilemma far more common than we care to admit. Maître Jérôme, as often is the case, made a compromise. He reduced the dose of the medication. Instead of taking it 3 times a day, he tried it only once a day in the morning to help him at least walk without much suffering. He resigned himself to keeping everything else personal the same. The comment he heard in the dream about teachers got under his skin enough that he needed to do some proactive remedy. Hence, he started a new process in his pedagogy.

He knew firsthand about the lot of the impoverished. He didn’t know the extent of the resentment brewing in some corners. Misguided resentment as far he was concerned since he wanted nothing more than help the underclass escape the morass of illiteracy and open doors for opportunities. Any failing student became eligible for tutoring, eligible like mandatory. He soon found out that often times, the real problem was the language barrier. Students didn’t understand the message and it didn’t register. Once he switched to explaining the concept in Kreyòl, the passing rate improved considerably. He also applied some very practical examples in problem solving.

X as an unknown in math, the focus of Lionel’s diatribe, received a special attention. The allusion to money’s magnetic pull was a clue to a practical means of piquing students’ interest. Instead of an abstract concept, when it stood for money, solving the riddle became a fascinating exercise. If instead it represented goals to be scored in a football tournament to achieve a ranking, the spontaneous participation of the game’s fans with their eyes wide open spoke volume of the power of teaching and the pleasure and satisfaction of enjoying the learning process. Pushing the right buttons made all the difference. In so doing, students who previously exhibited at best a lukewarm attitude toward math, warmed up to it.

Maître Jérôme’s personal choice of compromise didn’t fare so well. The reduced dose of the medication translated into more frequent pain while walking back home and still produced nightmares of lesser intensity but still frightening. He had to pick his poison. Tramadol passed from a necessary evil to just plain evil, never mind the good pain relief it offers. He could no longer throw the can down the road. Some hard choices needed to be made. Then what after stopping it? Another medication means having to deal with other potential side effects, known and unknown. His pet peeve remained the idea of facing his food addiction. In his lexicon, any toning down of his ravenous appetite amounted to torture, a turnoff to think about, a calvary to endure, an undeserved punishment being meted out. He was at wit’s end trying to figure out a way out of his imbroglio. Were he to try to eat less, his companion’s enrapture with cooking would stand in the way. The aroma of food elicited a response he had no control over. Such was his internal tug of war when he went to bed. An impetus to change his ways came from the least expected corner. That night when he tried to have sex with his girlfriend, the sciatic nerve became aggravated during a thrusting movement.

As luck would have it, sex and food were in a tie for his favorite pastime and as coequals there was a tacit understanding of no competition or better yet, no interference, as a sacred covenant. That sacred vow went up in smoke that night. That was an indisputable epiphany since he wouldn’t live a normal life without this intermittent carnal excitation. The pain was so bad he had no choice but to take a Tramadol. It brought some relief and then some. He had another nightmare where he lost his erection while trying to have sex due to a side effect of a medication. “This double whammy of gloom changed the equation,” he said to himself. “Equation?” he thought, noticing the potential pun. His bread and butter entailed solving equations. What he needed was less abstraction and more hands-on intervention. Thinking like a mathematician that his happiness was a function of several variables like the previously enumerated troika wouldn’t cut it. He needed an engineer’s hat and to come up with a workable solution. Or in blunt terms, he needed to man up and not whine.

On his way to work the following day, while walking and musing over his lot, he remembered the famous Newton’s quote about his walk on the beach and finding a good pebble or a pearl of an idea. He couldn’t prevent a thug from hurting him, but he definitely could influence his illness by actively following the rest of the doctor’s advice that he had conveniently chosen to forget. Physical therapy was out of his reach because he couldn’t afford it. His only option was to swallow the bitter pill of the concept of dieting and to find another analgesic less powerful but that can take the edge of the pain. All the same, the concept of dieting sounded as weird as the sun rising on the wrong side of earth.

He asked for and received the professional advice of using ibuprofen with meals as needed. The medication surprisingly worked without any secondary effect so long as he took it on a full stomach. Somehow the stars were aligning against him: he wanted to cut down on his calories, yet he needed to take a medication on anything but an empty stomach. Go figure. He dutifully cut back for one whole week. Came Saturday, his companion made the customary “fritters night.” This was a cornucopia of fritters of plantain, pork, malanga, and sauteed yuca, all bathed in a well-seasoned sauce with the can’t-do-without rice with beans. The pièce de résistance was the pen patat (sweet potato pie). This is also known as the diet-breaking formula, tasting so good like a sin. It should have come with the following warning, “This recipe is the perfect antidote against any silly idea of reining in your appetite.”

What followed next could only be understood by a foodie. The sight of the food activated his smell and taste buds into high gear. His stomach started behaving like a large crater with innumerable sensors sending signals to the brain that they were aching and in great need of filling. In what is smartly described as positive feedback, eating begets more eating. In a showdown between his willpower and intrinsic adaptation for survival, the latter was winning hands down. And a pleasurable win too, with joy evenly distributed among the palate, tummy, and the happy center of the brain. His indulgence mimicked the overreach of the starved, as if he were making up for the week’s prior restraint. Dinner was over at around seven p.m. He went to bed at 10 p.m. but found his way back to the kitchen at 1 a.m. for another generous serving. All the while knowing full well he was transgressing but he was capitulating gleefully to stronger forces, come what may. As if he was following the consign of eating and enjoying it now and feel guilty later.

Maître Jérôme the teacher gave an “F” to his alter ego the student in the throes of trying to solve a real-life struggle of limiting one’s indulgence at the table. This calamity transcends social strata, gender, age, ethnicity. This universal malady, addiction, receives separate judgment if due to nicotine, alcohol, illicit drugs, or food but by far has been misunderstood by the unafflicted. He was discovering that turning the tide was no less than a Sisyphean task literally. An endeavor littered with more backward steps than forward ones with the setbacks resetting the starting point with swift truculence to humble the most exalted. A situation similar to the path in a funnel where it leads to the narrowest space, enough to smother one.

His travails, like a stationery spinning wheel, pilfered his energy in a negative sum effort, sliding into a pattern of self-fulfilling prophecy where the advent of the predicted loss discourages further effort. His personal drama pitted so many reasons for a needed success against so many factors in place for his failure that its narrative is worthwhile sharing.

Maître Jérôme was above all a member of a group of survivors who adapt to extreme conditions and have acquired remarkable resilience. Variably described as minimalist outlook or the winging attitude, a practice of finding ways to survive in the face of reduced resources and or to improvise along the way. His long road began with a conversation with his mom, “So tell me my son, you are too proud a man and think you know so much as to forgo asking me for advice? Why is it I am finding out from a third party that you are suffering from back pain? Did you forget about Man Basi? You know she can fix you in no time and make you battle-ready?” This was prima facie evidence of a resourceful adaptation. His mother was referring to a gifted masseuse who had no formal training but whose hands with gnarled fingers and all had the ability of kneading and relaxing sore muscles. Those same hands have been known to massage one’s way out of the painful irritation of a pinched nerve in conjunction with a salve made of herbs extract. Maître Jérôme felt conflicted about the choices offered. He would prefer to go to see a Physical Therapist rather than to mess around with a masseuse. He had seen her at work and was fully aware of her abilities. Not wanting to hurt his mother’s feelings any more than he had already done, “Ok, I will try her.” His answer was more to assuage her than out of conviction.

Any misgivings about the masseuse evaporated into thin air after the first session. Man Basi’s hands did bring a soothing feeling and the salve applied did play the role of an analgesic. After a dozen or so sessions, he felt well enough to venture into an old habit of his, bike riding. He was feeling better and more of an upbeat mood. His relationship with food however remained unscathed. In fairness, what we call gluttony was a different matter altogether from his perspective.  Truth and beauty pervade the eyes of the beholder, and this is no different. “People enjoy listening to classical music and will spend hours doing so because they get a fulfillment out of it. Others find delight in reading and while some go fishing for the joy or the high they derive from it. My enjoyment of our gastronomic delicacies is no different. Great food is the sibling of great sex. Simple concept and long-lasting pleasure both physically and mentally.” One would be hard pressed to find a sensible counterargument considering all the efforts he was applying. Of course one could always argue it was a stretch to compare the previous activities to calories-gaining endeavor, but the idea of partaking into an activity that creates joy warrants our respect.

Maître Jérôme’s new regimen worked… until it didn’t. Biking slowly but steadily became an also-ran activity, a second fiddle to slouching, like a true potato couch. His activities followed a yo-yo pattern, with highs of energy and lows of lassitude with bingeing closely associated with the low periods. Once the bingeing started, there was no stopping it. At his lows, he had no explanation for his behavior and no desire to undo any ongoing damage. While exhibiting obvious signs of acute depression, this diagnosis was not to be uttered. “I am not crazy!” As if derangement in thought was the only type of mental disorder. Treatment couldn’t possibly take place absent acceptance of condition by the afflicted.

Addiction, depression a notional duet as intriguing as the eternal debate of the chicken and the egg. This distinction without any meaningful difference differed entirely from the misgiven impression that mental illness equates schizophrenia. Therein lied the big dilemma of Maître Jérôme. A dilemma that didn’t seem to have any end. The saga was still evolving. His low period was now associated with diminished libido, a nonstarter in his relationship with his live-in girlfriend. He could tolerate the whining from his mom but the decibel and frequency from that of his girlfriend went off the chart. She took fussing to an art form and she didn’t take too kindly to no as an answer. “I want a stud, not a dud next to me in bed.” “My flower needs to be wet from time to time to make me feel like a woman.” No string of expressions can seem more emasculating than this. And if it didn’t work, she would stop cooking. He couldn’t stay indifferent to that type of pressure.

Under duress, he sought help and went through a whirlwind of hits and misses. Meds for the depression would either outright cause impotence or diminish his libido; insomnia or nightmares would join the fray at times. “I don’t know which is worse, the treatment or the disease,” he would sometime complain. The trial and error worked when a reduced dose of an antidepressant worked to steady his mood without any interference with sleep, libido. Never mind it seemed to muck up the weight issue. A lower bar of expectations became the new standard. Get what one can and see what happens.

Maître Jérôme’s battle with the bulge, depression, pinched sciatic nerve and medication intolerance followed a zigzag pattern until it reached cruise control. Bike riding every week with some weeks more often than others. His weight devolved into a holding pattern, neither gaining nor losing more than 5 pounds at a clip. He finally rationalizes his abdominal girth, “Mother Nature didn’t intend for everyone to be slim. My dad’s belly wasn’t small either. I refuse to worry about that. Let me concentrate on being healthy. As the song says, ‘Don’t worry, be happy!’”

The pain would come back every now and then. When it did return, he would find his way to Man Basi so she could do her mojo. He would rest from activities till he improved. His lovefest with food never went away per se. He worked around it. Saturday fritters were sacred. They were the equivalent of “gastronomic symphony for the tummy and the palate, an activity held in very high reverence under my roof.” Other days, he was able to limit his portions. Trying to accomplish more than this would add too much unnecessary stress and require too much recalibration. So long as he took his med and his girlfriend saw to it that he did, he was able to live a drama-free existence, similar to that of so many ordinary citizens.

He was able to escape the life of a funnel and settled for that in an airy tunnel with light at its end always visible, but the rear was dark. He had the choice of going back or going forward knowing full well the consequences of each move. To his satisfaction, the thug Lionel didn’t materialize in his life. He was able to stimulate a lot of students to tune to the elegant and descriptive world of mathematics. He gave himself a C for his private struggles. Folks would give him an A for his honest way of assessing his situation.


Reynald Altéma, MD

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