Anonymous asked me to talk about Repetitive Strain Injury this week, so as usual I'm using it as a prompt to expand on a wider topic: writer ailments.
Writers, alas, are notoriously unwell people. It seems to be a side-effect of the art. A recent book by John Ross, Orwell's Cough: Diagnosing the Medical Maladies & Last Gasps of the Great Writers (cheerful stuff), is dedicated to studying the various conditions from which our literary ancestors suffered. I'm not going to talk about mental illness today, because it's such a vast topic that it merits its own entry. Instead I'm going to shed some light on some of the physical conditions writers suffer when they push their bodies too far, and how those conditions work. Why does coffee wake us up, and why do we get addicted to it?
I've suffered, or suffer from, most of these conditions. I had them particularly badly when I was working on Aurora, when I was working for up to fifteen hours a day and generally turned myself into a wreck of a human being. I tried to be better behaved with The Bone Season, but I still get the odd problem. Remember, I'm not a GP, and this entry will only give a rough overview of each condition. If you think you might have any of these, do get it checked out with a medical professional.
Back pain comes in many forms, and produces many degrees of pain, but it's always unpleasant. It's often caused by bad posture. Writers can be hunched over computers or manuscripts for hours or even days at a time, which does your back no favours.
Ideally, you should be sitting at your desk with the top of the screen at eye level, your back straight, elbows close to your body, shoulders relaxed, feet resting flat on the ground (or on a footrest). The screen should be roughly an arm's length from your eyes. This all sounds like a lot to remember, but you'll naturally develop good posture if you set up your workspace properly.
Make sure your workspace is equipped with an adjustable chair that supports your back. If it doesn't, you can buy a separate orthopaedic back cushion. I use the Houston High-Back Leather-faced Executive Chair and the Fellowes Portable Lumbar Support, both from Staples. You might have to shell out for a decent office chair, but it's better than suffering in silence on a cheap one, and it will last you a long time. It's an investment. There are also heated back supports available if you want to be really decadent. Scroll down to RSI to learn more about proper wrist posture.
Like ink, wine and the sweat of our labour, coffee is one of the fuels that keep us writers going. Legend erroneously tells that when drunk monk Dom Pérignon first tasted champagne, he cried "Come quickly, I am drinking the stars!" That's pretty much what happened to me when I took my first sip of coffee. Suddenly I could get through hours and hours of writing without face-planting the keyboard halfway through a scene. Writing and coffee go hand in hand. Not all of us work well by day, and we need something to keep us bright and breezy as we work towards our dreaded deadlines.
So why does caffeine wake us up? Turns out it's a bit of a trickster: it fools the body into thinking it's a neurotransmitter called adenosine. Adenosine causes drowsiness by binding to receptors in the brain, which slows down nerve activity. Caffeine resembles adenosine and binds to adenosine receptors, but unlike adenosine, it doesn't slow down nerve activity - instead, it speeds everything up. Because the caffeine is taking up all the nerve receptors, the effects of adenosine are blocked, and you don't get drowsy. It increases neuron firing, confusing the pituary gland, which think there's an emergency and starts to pump out adrenaline. It also messes around with dopamine, the neurotransmitter that activates pleasure in the brain.
The three big effects of caffeine – blocking drowsiness, stimulating adrenaline and making you feel good – give your body and mind a short-term boost. French writer Balzac compared it to "sparks shoot(ing) up to the brain". It's easy to see why we keep drinking it. But if you drag yourself out of bed without a cup of joe, chances are you're becoming dependent on it. It puts your body into a state of emergency, making you irritable and twitchy, and if drunk at the wrong time, it can cause a ruthless cycle of insomnia.
When you make coffee, keep in mind that the half-life of caffeine in the body is about six hours. If possible, only drink it in the morning.
|Honoré de Balzac|
Properly called asthenopia, eye strain comes from staring at something up close for a long, long time – in a writer's case, that's usually a manuscript. It's caused by the ciliary muscle at the front of the eyeball, which contracts when you're relying heavily on your eyes to complete a task. This causes your eye to become irritated. You might get blurred or double vision, red or dry eyes, or a headache. Eye strain doesn't generally cause lasting damage to your eyes, but it causes an annoying, dull pain and can inhibit concentration.
The best way to avoid eye strain is by giving yourself regular breaks from the computer screen and focusing on a distant object. I try to take a break from writing at least once an hour and go for a walk, or look out of the window. Eye drops help, too. Make sure you work in a well-lit room. If you wear glasses, you can pay a small amount of money to get an anti-reflective coating on the lenses (suggested by Mohsin). This helps reduce glare and allows you to work for longer without straining your ciliary muscle. Lenses with this coating will have a slight blue-green tint to the light reflections on their surface.
A great piece of software, recommended by virtuefiction, is f.lux. I just downloaded it and it's brilliant. The light emitted by your computer screen is designed to resemble sunlight, which is great in the day – but at night, the harsh, bluish glow can strain your eyes and keep you awake, as your body thinks it's still daytime. If you get f.lux and give it access to your location, it detects the time of day and after sunset, it will give the screen a warm, orangey tone, like indoor lights.
Literary sufferers: I haven't found any specifics for eye strain – I think we can safely assume that most writers have had it – but there are lots of cases of eye problems among the literati: Aldous Huxley (visited the therapist William Horatio Bates after an attack of keratitis and later wrote the book The Art of Seeing detailing his experiences), Emily Dickinson (suffered from an unknown eye affliction – possibly uveitis – that caused sensitivity to light, beginning in autumn 1863, for which she received treatment from Boston opthalmologist Henry Willard Williams) and James Joyce (plagued by eye problems throughout his life, including uveitis, glaucoma, cataracts and conjunctivitis) among them.
Migraines are my blessing and my curse. I really ought to thank them, because they gave me the idea for clairvoyants to be identifiable by their aura in The Bone Season. I first started getting them in 2009, during my A-Levels. The first time I had one, I staggered to the optician and begged them to stop me going blind. As it turned out, I was experiencing a sensation called scintillating scotoma, which is basically a big, glimmering, multicoloured obstruction in your vision. (The picture in the left is an artist's impression of a scintillating scotoma by Tama Blough.) Scotoma can manifest in a variety of different ways – partial loss of vision, for example – but for me, it's like a kaleidoscopic firework show bursting in the front of my eye. I drew heavily on my experiences with migraine to invent the visual aspects of The Bone Season, including aura and the spirit sight. So thanks, migraines.
Migraine comes from the Greek word ἡμικρανία, roughly translated as "half-skull", referring to the tendency of migraine to affect only one side of the head. It's thought to be caused by chemical imbalances in the brain, specifically low levels of serotonin. When serotonin levels drop, the blood vessels in the brain spasm and contract. This is the phase of migraine that causes aura in some migraineurs. This contraction is followed by sudden enlargement of the blood vessels, which causes the pain. There are also various environmental, dietary, physical and emotional factors that can trigger a migraine. Bright lights often get me. When I get a migraine, it feels like the front of my skull is several sizes two small. You might also experience a sensitivity to light, nausea and vomiting.
There are a number of treatments for migraine. I take a drug called sumatriptan, which stimulates the production of serotonin. You can either take the pills when the migraine starts, like I do, or take pills regularly to prevent migraines coming. I often find myself getting one when I write. I always know when it's coming, because I'll be working on a chapter and suddenly won't be able to see whole sentences – letters will suddenly go missing, sucked into the little blind spot that will grow into a scotoma.
|Miguel de Cervantes|
Literary sufferers: Creative types are apparently more likely to get migraines. Literary migraineurs of the past include Emily Dickinson (sometimes assumed from her 1863 poem 'I felt a Funeral, in my Brain'), Miguel de Cervantes, Virginia Woolf, Rudyard Kipling ("One half of my head, from the top of my skull to the cleft of my jaw, hammers, bangs, sizzles and swears"), Lewis Carroll and Charles Darwin (he called migraine his "hereditary weakness", and was unable to attend his father's funeral because of it).
Repetitive Strain Injury (RSI)
Often linked to writing, RSI does what it says on the tin. It's a musculoskeletal condition caused by repetitive tasks like typing, lifting, or using a phone keypad – tasks which involve you overusing certain muscles and tendons. I get bouts of RSI when I work on a manuscript for hours at a time over the course of several weeks.
RSI is easy to prevent. You'll feel it coming: stiffness in your fingers, sore wrists, painful muscles and joints in your arms. Part of prevention is ensuring you have good posture when you write. Ideally, your wrists should not be bent in order for your fingers to reach the keys. You can buy a wrist rest, usually soft or filled with gel, to keep them in a neutral position. This is placed in front of the keyboard. I use the Fellowes Crystal Keyboard Wrist Rest from Staples.
The most important thing to do is to take regular breaks. Still, if you write a lot, especially to tight deadlines, it's worth buying yourself a little anti-RSI kit. Be sure to include wrist braces for when your wrists get painful. I use the cheap 'n' cheerful Elastoplast Sport adjustable supports from Boots, but there are lots of different kinds, each providing different levels of support. Another handy remedy is cod liver oil. It's often used to ease the joint pain associated with arthritis, but it can also help with RSI. You can take it in liquid form, but it tastes as rank as it sounds. I use the Seven Seas brand and take it as a capsule, one every day. Just don't bite the capsules, no matter how much like bottled sunlight they look. You can also try soaking your hands in Radox and warm water.
Two conditions thought to have similar causes to RSI are focal dystonia and carpal tunnel syndrome. FD, also called writer's cramp, can lead to loss of fine motor control in the hands, curled or stretched fingers, and a myriad of other symptoms that can interfere with writing. Treatment will vary, depending on what caused it. CTS is caused by pressure on the median nerve, which gives feeling to the side of your hand your thumb is on. This can cause numbness, tingling and pain in the affected hand and wrist.
Literary sufferers: Franco-German philosopher, theologian and organist Albert Schweitzer. Schweitzer is thought to have suffered from focal hand dystonia, though he was never formally diagnosed. He used special pens to combat the condition. The cramps in his arm were triggered by handwriting, meaning he struggled to form coherent letters – but it didn't affect his famous organ-playing.
Do you suffer from an ailment related to writing? How do you cope with it? Has it helped or inspired you in any way, like my migraines?