Skin

I was just picking up a shirt off the floor in bright sunlight. It was astonishing, and gross, to see so much dust floating in the air, after wearing the shirt ~once, and with a camisole no less!

A cloud recreated when I moved the shirt with a jiggle[1].

Big to small, there were more and more particles; as the shapes got tinier; for example there were what seemed like millions of fine dust, presumably from skin scale, compared to

one or two cat hairs,

8-10 ½ inch long hairs,

60-80 ¼ inch lengths (probably from the clothes themselves-wool in this case but are tomorrow’s nanoparticules, these are tomorrow’s great-grandparent fibers).

Progressively smaller,

Ever Multiplying –

towards the invisible

my eyes couldn’t see anymore.

I could only imagine the number of particles there would be just under my visibility, let alone on a microscopic level- and on top of Avogadro’s gases[2]! [3]

Just because we can’t see something, doesn’t mean it’s not there!

In the clouds’ characteristics the distribution of particles visible, seemed in repeated relation.

The largest were the fewest, already I could tell –

the longest and most prominent

Indeed they dropped most quickly,

To the ground as the cloud settled.

These are aerodynamically heavy

Elongated and dense

Without side branches or splitting.

On their own steam, they fall more rapidly,

Swirling the lighter ones out of the way;

No particles stop or

even slow them down[4] .

They fell straight down from where they were shook,

and landed (splat) more quickly.

But therein were many intermediates too –

that seemed to fall more slowly.

These floated with visible differences in buoyancy

seeming buffeted by unseen forces.[5]

More like dandelion pouf or fine flour drifting,

Easily measurable

The lighter, smaller pieces floated

Some taking much more time to settle than others.[6]

*****

I just learned yesterday, the Chinese can tell you, using “four pillars” astrology,[7] how your life energy got dealt and predict how you approach challenges in life (see footnote).

How most have four half-decent ‘legs’ – the root of your “stems and branches,” as well as a set of strengths and weaknesses associated with each. These reflect how you might evolve in your being as you go through life’s challenges.  

Most go through life not leaving big measurable achievements- but overall contributing to the fabric of one’s world of community. At points in life feeling invincible, sailing, getting his or her fifteen minutes of fame, etc. but then too responding to challenges and life’s lessons.

Then there are those of us with the equivalent of three heavy legs and one almost missing. Famous (or infamous) characters throughout history  ones known for their manifest creations. How you judge them is up to you; try to be forgiving.

All have intense and painful back-stories in their telling; and experienced strong needs to focus. Though I have come to see mine as “beautiful and dangerous assignment”, rather than broken. That feels far less poignant.

With four legs, falling heavy leaves you with splinters –

but with three legs you’re more unstable.

That missing one takes active management.

It’s needs will call and maybe one day not too pleasantly.

It is helpful to be willing to strengthen what’s missing

Pray for in G-d’s time and with Grace.

When your platform is sound, and tests completed,

You’ll stay whole just the same[8]– (Inshallah, of course!)

*****

It’s the feelings

you have to heal from-

and what you do that re-opens them-

at least until now.

*****

The ‘dust’ I observed- still fell with the same acceleration of gravity[9];

It obeys laws in Newtonian reality.

Time being measurable

while gravity felt.

How we perceive time or gravity subjective-

Our experience immeasurable

(or at best dimensionally conscribed) from  the other’s perspective.

But uh, this must be completely self-evident?!

Just as we all age, seemingly

Some more graceful than others,

There can be lightness in being

As we inevitably settle[10].

(…and that, our lungs are built to deal with particles, just look at that shedding!)

*****

When I was an allergy fellow at UVA[11], we would have patients in the clinical research center with severe eczema. While this was a small percentage of patients I’ve seen, ~ 1-2%, this important set significantly drives objective “costs” of the medical dollar.

I’ll use their plight and stories I’ve witnessed, to illustrate some contradictions worth considering.

These folks have skin that is ‘unhappy’.  It looks veery uncomfortable- sometimes like boiled red lobsters[12] bristling with dry flakes. Often they are incessantly focused on their skin or scratching while they visit with me. It’s difficult to watch them seem so miserable[13] and side-lined.

So we, the principle investigators (my program director and his colleagues at the time) have them come in for research protocols- to (experiment and) see if our special elemental diets and treatments help them – which it does, most of the time[14]. [15]

Over the week, the nurse or her assistant, measure skin scales (and subtract the bedding), to document their progressive lightness[16].

That is good news – as over those 2 or 3 weeks, almost all do get better, their skins slows its shedding. The weight shed reduces. So we could prove to them, it could be done.

Unfortunately even though benefited, many relapsed. Most of these folks, always the most severe (that’s why we studied them), would go home to their families and flare again as their diet deteriorated.

When I’d meet them, wherever they were in their journey of therapies, they’d sometimes say to me there was “no use” to anything I might offer – expressing their sense of futility – after they’d tried several treatments and therapies –on top of their strenuous regimen, to yet again fail.  

It was sad to see attitudes seem to worsen over time (or was this my projection too?!) after too many promising treatments fall short.[17]

*****

I have noticed some interesting trends during my almost thirty years of seeing people with these disorders. A few things stand out. First with severe eczema, patients are almost all were female girls or women.

[Wo-men, the ones with the wo(e). We women carry sorrow; it’s part of our makeup- to create in spite of death around us; it’s men who draw from us. Forget penis envy; this is a myth to shame us.]

When I asked them their story, what they suggested was of a need for attention, structure, and to express a will otherwise denied. To an outsider (anyone not her) might be thought of as “negative” behavior[18].

Many of these children and young adults have their moms fluster all over them. Most adults are single. I thought it curious how their flares were often coincident with a feud (with their mom or boss) while their skin flare creates diversion and momentary distraction, it also brings them back into their body and forces them to feel senses[19] (instead of focusing on those uncontrollable and painful woes).[20]

A few, the ones with special triggers, might repeatedly “forget” and eat the culprit food- even when it could make their skin itch for day or more. Who does that?

One girl had the timing down to eating one specific cookie, before she’d become a little red flame for almost 72 hours. Then, and only then, could she get her family off her back, or to stop them from squabbling about what they couldn’t control (they’d focus on her).

Forcing mom, especially, to go into nurture mode- to provide water (emotions as nagging) and soothing (emollient).

[Oh wait! Making mom do something soothing every day IS helpful -if you remember the old saw[21], “happy wife, happy life”. She can choose her attitude.]

Objectively there was truth; it was the only for many to have control of – what she put in her mouth and how she made her bed in the morning[22]!

Another young woman, was an only child and her parents were unbending. She was very sensitive to a number of particularly ethnic foods – of her ethnicity (like shrimp and soy, when she was Asian).

After all, her parents scrimped and saved in order to give her everything they felt deprived of. They reflected the severity they endured while fleeing their native lands and coming to a place (the US) with its inhospitality… and so it goes.

Providing through sacrifice, they did force her choice of studies or else wouldn’t pay for her. Or so they’d told her. What she wanted was different.  Feeling stymied, she got back at them.

Most ironic, on occasion mom served the foods to her knowing full well the next few days of outcome!  That’s some serious confusion. There were no mistakes in this picture.

 Treating her was an ongoing lesson for me too where what I told her might encourage changes she might not be willing to make yet- nor make her parents too happy.

There was an article in the New England Journal, probably in the early 1990s, about children with atopic dermatitis coming from families with high disorganization.

In both cases, control issues manifesting as eczema flares. Hmmm, how curious!

Perhaps offering that insight would have been helpful. Perhaps, but I doubt it[23]. You can’t change people (it turns out)- only support them while they’re shifting. Plus she enjoyed seeing her parents vexed; It was her way to get back at them-they left her so little room for autonomy.

********

No doubt she could be considered a candidate for one of the new biologics that cost a small fortune, but unless hers is a “Cadillac health plan”, her condition will not be covered[24].

When entreated with that option, then denied, that denial alone can add to her (justifiable) sense of lack of autonomy. Becoming ‘victim’ of another externally ‘unfair’ system (this time doubly manipulated).

******

But many did, and do, get better – from just a single visit. After careful listening and an action plan, they learn to manage their dis-ease, as surrogate for their stress, and to use it as a warning.

Those eczema patients,

They got better, the children I mean,

They lived, they became-

With (or without) our expert wisdoms,

Nurses, and white linens.

Treating them with ritual and tenderness

Gave them a bit of specialness.

*****

Yet, the mystic in me wonders, what’s this dis-order really about? How does it serve?

I sometimes have nice linens. They too get shed with skin scales at the end of a night, not that I see them like my patient friend; for now it sheds more sparsely.  Fortunately it would take months (I hope)- but then, who’s weighing them?

Still I shed continuously and in cycles and with the seasons, as do you, and yes you do too! Who are we becoming as we shed ourselves daily? Monthly marching through the hours, whiling away the years.

What has our being cast off in our wakes?

How are we lived our lives with our skin scale train behind us – and how do we carry it? Our skin trail binds to us like karma, where we’ve been, is a tail connecting[25].

As we shift and gain comfort in our new skins, may we shed less and leave a trail even lighter[26].


[1] It struck me the lung deals with particles just fine- it’s immersed in them- it’s chemical and dys-microbial proportions and exposures that matter.

[2] 6.023 x 1023 particles in one mole of pure substance.

[3] The funny thing, What we see is an inverse reality; a surface being collection of photons, underneath manifestations of invisible attractions and entity. Fun stuff. I thought if I played by the rules it would spare me.

[4] Like many men I witness negotiating in particularly autocratic or abusive way- or so like I saw in the news yesterday- could be many like a Donald Trump or Vladimir Putin. “Manly” men they do embody at least for some including me. But there are so many stallions out there, it isn’t funny.  All groomed for lovely ‘racetracks’- where the bystanders make monies. As a mother, let alone friend, one has to stop back and watch them make mistakes you know will be painful and yet, they must go their own way – as they reap what they sow, even if its right down to the floor.

Until then they’ll not know Grace if they are ever open to meeting her.

For she exists, only when ‘he[4]’ surrenders.

[5] Could have been an illusion, I won’t argue.

[6] like a micro-aerosol, but won’t go there today- I cut this essay out of a much longer one.

[7] ~ The year of birth determines your Chinese ‘animal’ (Jupiter- expansive self) in a 60 year cycle as Jupiter progresses each year through the five elements; the month -resources and health (seasonal availability of food), the day ~your dharma/work direction, and hour of birth ~engagement with other- or some similar equivalent.

[8] Unless there’s a big force slamming you senseless to the ground; otherwise three is a tripod to keep balance OK. But three are weaker than four when weight is applied; then both you and your ‘weight’ go tumbling! Those missing legs are ours to fix; our dharma before we can manifest with stability.

[9] The dust surface (formations of crystals) makes the difference for how fast the particle settles. Aerodynamic differences from shape and weight, affect’ drag’- (Tiny even) energetic attachments to surroundings, as the mote moves through it.

[10] And around our midriffs for many!

[11] University of Virginia

[12] When they have erythroderma (looking like boiled skin all over) this is considered a medically emergent condition.

[13] Me anyway- because I seem to have a bit of synesthesia for mirror touch.

[14] I always wonder about these outliers- but then, I am no public health doctor. Nonetheless, details of the exceptional often seem to guide policy dollars.

[15] They almost always got better with our lovely and kind nurses drawing baths four times a day, helping them with oiling all over afterwards, then binding their excoriations and weeping. They’d be given a very specially tailored diet, but no candy or treats. Lots of encouragement and coaching garnered their attention- but this was before ipads invention. Of course there was TV.

[16] What a disgusting job for that nurse to do – most of them bloodied by the patient’s sometimes obsessive picking and filled with the sallow yellow of visible skin slivers. Mercy!

[17] Why did their attitudes worsen? Now they felt more frustrated – all those other things not helping anymore. It makes many clinicians uncomfortable not to have new treatments; and the squeaky wheel gets greased. Many of us physicians overpromise with our ever-catering codependency and need to for approval.

[18] BE compassionate- love is our heart’s need, (will is our desire). What we will do to create- is subconscious for most of us.

[19] Itching is a low-grade pain – and signal that something (the ‘consciousness’ from the needs of a hive mind) is being tickled or taxed.

[20] Break the upsets- create an opportunity for binding (usually with mother as she puts the dressings on the young ones).

[21] A “saw” is conventional wisdom and usually includes “superstition” meaning to stand under – as if an invisible force. Who wants to be under that, that means FEAR. Just the idea makes you shrink and want to hide. No wonder the word superstition is derided in 18th century and beyond dictionaries. Make fun and shame those who believe in a higher power (than the wise men at Oxford and in his universities Unseen).

[22] OK there are a few other things we can control – our hygiene mainly, at least that tends to stay the longest as we age and enfeeble.  I aim high and work hard, but my ‘luck’ is in G-d’s hands. One big hurdle in 12 Steps is to be able to consider anything outside us as “higher”. That defines a consciousness that is lower – like looking into the void – not ‘seeing’ anything (no Ayin- no attachment or (allusion of) promise in materia), but having to step out anyway, trusting there is an invisible hand waiting to hold your footsteps (a quality of Aleph). What is that hand? Is it Grace that put it there?

[23] If you don’t want to hear it, I’m not going to tell you, at least not if I can’t without getting your goat up. Being defensive blocks receptivity. You’ll find out just fine by yourself -may your teacher be wise and kind.

[24] Although in this particular case, because she does have military health care, it very well will be covered for around 30K/year- indefinitely! There are no assessments to ascertain for emotional components. Enjoy that idea…when a 12-step program made normalized for any situation you can’t control, might really alleviate some of these conflicts.

When you start suppressing, blocking, or shifting any gene’s function (dupilimab is antagonistic block to Il-4 Receptor) about 30,000 genes will respond – to try to get her back into ‘balance’ – subconsciously, as her skin condition may be an unintended consequence for up-regulation of that receptor pathway (which has myriad effects).

[25] Imagine everywhere you go, everywhere your feet have touched the ground, you can connect and tether (if you want to) to make your way back spiritually or materially, especially if you ‘leave’ a token for particular remembrance.

[26] Everyone sheds white; there is little visible melanin in our dried keratinocytes.

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