Interview with Robert Markison
Full Text
March 12, 1997
r is robert markison, the loquatious doctor.
j is me, justin, sufferer of hand woe and faithful student to many.
a is amy, my intrepid girlfriend and occasionally photographer.
becky typed this up for me, for money.
j - what about anti-inflammatories?
r - i think they're over-prescribed and overused and the hidden problems are liver and kidney problems, the more obvious problems are stomach problems and they're just going to cover up immflamation, not really good for you and unfortunately the knee-jerk response of many practicioners who treat repetitive strain injury is to splint and drug the patient 'til they go away
j - the patients or the problems right? so what about arnica?
r - it can be helpful as a topical anti-inflammatory
j - yeah, that's one thing that i found great, cause i never use advil ever, but i use arnica all the time
r - can be helpful. absolutely, worthwhile. ok so "you're trained as a western doctor alternative medicines or treatments
j - well that's what i've asked, just some of the vitamins, arnica, stuff like that
r - that's it, that's it, ok so you've run into people
j - i've asked about this, we've covered this
r - i don't say there's no place for steroid injections and i don't feel there's no place for surgery, but, i operate on a small fraction of patients with repetitive strain or cumulative trauma and it's gone. as far as a national listing [of hand doctors]? no, we have the american society for surgery in the hands and frankly not all of us are interested in cumulative trauma or repetitive strain.
j - yeah
r - and it is debated, even within the field of upper limb specialists as to whether it exists other than the unhappiness of people who don't like their jobs. i mean in the worst polar biased view on repetative strain is just simply complaining people who are unhappy. and it's all psychological and minimally physical.
j - well, regardless of the problem, right, that's what, that's that key,
r - it's a problem...
j - so how do you answer that
r - it's a problem that won't go away and every cumulative trauma is a psycho physical matter. the psyche lead the person into either the wrong job or just too much of it. and then the physical aspect of it was, are they cut out to do that particular work? and not everybody's cut out to do every job. not coincidental that football players stop when they're 30. there's some things, you just run out of touchdowns, you run out of the keystrokes, you run out of something. that's either ok or not ok depending on how you put bread on the table. but i think some people are geared to doing it long term, as you mentioned art tatum, some people are not. and it's really a matter of how you handle information, and how much brain, how much hand,
j - yeah
r - you dont want to endlessly enslave your hands to activity that's not productive. more brain, less hands, i mean at anything - whether you're a musician or,
j - or very much like you said, haiku, so hm
r - that's right, you express yourself with minimum words
j - it's a question of, so, you know, i have friends, they all say, 'oh, my arms hurt', you know they're working, i tell them 'ok, take breaks, you gotta take breaks, you gotta change your behavior' - now, but is that, when you're working on the computer and your hands begin to hurt, what do you do then? is that the time to go see a doctor, is that the time to..?
r - no, no, unless its a lingering problem where it doesn't go away overnight, and doesn't go away over a weekend then you might see someone. taking breaks is sage advice, staying very moist, well-hydrated so at least you take pee breaks is very important... and shedding stress, learning how to breathe, learning some form of medication that can be on the spot - just right there do it - close your eyes, take a few deep breaths, imagery of warming your hands so they're fit to work, unraveling muscular tension between neck and fingertips, understanding how much the keyboard stuff is necessary and how much it is not. cultivating ambidexterity for use of perimeter keys, being able to get alternative devices like the split keyboard or perhaps the foot mouse, whatever. whatever you can do to offload upper limbs and not enslave them, again repeating some of the things we've already said, but just think if you're still intense that you're way forward with head and limb that you're going to start to crush nerves and vessels and above and below the collarbone and if you start to do that, by head and limb forward postures, in the name of getting toward the box, and the keyboard, and the mouse, then you're in trouble
j - but when are you doing permanent damage? is that an issue?
r - it may be an issue and its just a question of how long symptoms linger. if they linger more than overnight, and it's night after night after night, then you may be doing some damage, but the problem is, on a scientific level, its not quantifiable, you can't go in and take tissue, run it under a microscope and see obvious inflammation. when you take tissue out of these limbs, it generally doesn't show anything and so it's hard to know, except for the psycho-physical aspect of being
j - yeah, there's no external signs of this kind of stuff, right?
r - right. there are aches and pains and when aches and pains get to be more than that, and they linger, then you're going to have to fundamentally change your ways and that's very vague and not quantitative. as far as permanent damage, i've now had follow up since 1982 when the IBM PCjr was mass distributed, that was 15 years ago, in '82, so now, 15 years later i've seen people who've made good changes and are doing fine but most of them are not at the pre-injury computing level.
j - oh, i see
r - nor do they seek to be because they see it as the fire and the cause and the injury.
j - i've shifted my behavior enormously since, i've gone, i try, i first, i healed somewhat after i saw you and then i tried to return to that level and that was wrong and i injured myself again and so now what i've done is i've moderated my behavior to shortened sporadic, you know, well breaked, well hydrated use of the computer but it doesn't seem like, i'm not seeing results in weeks, it seems like months or years from now until the pain ....
r - you get RSI and it's foolish to think that six months is going to do it, its more like one to two years like tennis elbow is one, two or three years. if you want to naturally heal tennis elbow in one, two or three years,
j - wow
r - and so most people in this giddy phase of impatience and no weight state with rapid chips don't understand good old patience and good old natural time but its there and it takes a long time
j - but i can't think of what i could do to be creative or to be productive without my upper limbs.
r - right, would that you had asked that question before you go into intensive computing. we don't know what we've lost 'til we're losing it. and so you're in a position where your self-rescue can be a good steady one cause you're a smart guy. people who aren't smart have fewer options and so you really have to take stock of identity, iq, and whole history - you know where you've been, where you are and where you will be
j - but i think i could take up sculpture but i don't know how that would be for my hands or i could take up house...
r - depends on the medium, depends on the medium, if you're doing fine little sculpture and you know, you're working in a warm media where you're not doing cold stuff, throwing it on a potter's wheel. you could do some sculpture, certainly you could
j - so i have to consider, if its not fine motion, right, it's not
r - some of it, it's not going to be relentless fine motion, you can certainly do sculpture with some tools and there are videos on how to use them
j - but gripping a hammer, building a house - that wouldn't be...? i mean all these things, i guess anything in moderation becomes ok?
r - more power tools, yeah more power tools. there's some wonderful power tools out there, i mean .....use a screwdriver
j - what about learning the piano? i thought about learning the piano.
r - yeah, but if you're learning the piano, you know, here follow me and then we got to close off
j - yeah sure you bet this is the last series of questions i think.
r - yeah sure but you know if i were going to
j- or the guitar for that matter
r - yeah, right. if i were going to do piano, then i'd get a synthesizer where i had something reasonable so that i could go, instead of this i could go like this , and then go and i'm looking at it and the rest will be dark. and you see what i've done here, i mean i'm not even playing it but i know exactly what i did, i know the blacks, i know the whites, i know relative positions of fingers and i could sleep on what i just did, good or bad. and that would be the end of it. so then i've really learned something and really looked at it infinite number of times since its self-storing and self-recording so then i don't have to do this ritual, oh well god i didn't do it didn't do it didn't do it, i'd say, yeah,that was 20% good. i flunked 80%, lets go for 30% tomorrow.
j - but its much more studied, its much less the rote action of pounding the piano, much more the consideration of , huh, ok
r - that's fine, that's why i got that, its wonderful, beautiful, beautiful .... but its self recording
j - its a yamaha what?
r - TSR420
j - and what? i guess to wrap...you have email but you don't spend more than 15 minutes a chunk on the internet?
r - yeah, a day, or every other day 15 minutes maximum online.
j - like surfing the web or something. cause this interview is for a website and part of the website is where people can read the article and then put up a question or something like that, saying 'oh dr. markison, 'i read this, but what about this?''
r - it's going to be tough to respond to any of this and i feel bad about it
j - well, i didn't ask you to respond because i know how taxing your time is
r - can't do it, but, i can't open the floodgates to letters and email right now. i'm too busy, but in reference to some articles, the keyboard article, you know, some other stuff might be helpful and that's in the cv. as far as other ways to get through, you know there are online things and i don't frankly agree with a lot of stuff you see sore hand and other things that are kind of on-line groups for repatative strain injury. some of the stuff's interesting, some people are just angrily flailing around about their limbs, but i, i hope to write more and my input will be more evident in deborah quilter's forthcoming book and that's a few months away 'living with it, recovering from it'. if there are any people out there who are really interested in design and really want to think about how to design, i might or might not be interested but i'm constantly looking for people who are smart enough to know that they know nothing. and that's when you really meet a smart person, they admit they know nothing and they're willing to start at ground zero and learn. and in my own thinking, my own sign, i think of a glimmer of intelligence is that i'm willing to wake up every day and know that i know absolutely nothing. and unfortunately there's too much hubris and too much conceit and arrogance in big industry right now. with their "not invented here" syndrome and everything else, to say, 'we don't know anything and we're proud of it. let's learn something, let's go back really to the beginning
j - and we can offer ourselves
r - nobody'll do that any more. too much proprietary knowledge has only lead to injury,
j - too much what?
r - proprietary knowledge, you know, smart people say, 'oh we've got the goods on everything already and it all starts here'. we don't need to look outside
r - that's a dangerous way of being i think. we are where we are with poor industrial design in the field of computing because too many people thought they knew a lot. and none of them knows anything, any day of the week. that's why the relentless learning. constant curriculum, constant pick your syllabus, go to primary sources, hopefully find some living masters and study in enormous depth before you put your hands on anything. then you're fine. i didn't make a pair of shoes until i studied the history of shoe-making. until i watched a lot of shoes made. didn't do it, i didn't play the clarinet until i really listened to benny goodman, artie shaw, the great classical clarinetests, i wouldn't do it, i'm not going to do anything until i've really surveyed the landscape. that should be the way we learn and be as far as i'm concerned.
j - i'm much more of a, i'll try to make a purse and that'll be my way to understand purse-making
r - that's good, that's good but you can do a lot of hand use - abuse - overuse
j - by not precognising?
r - forethought preceeding actions, that's the way
j - i can deal with that, wait - when's your birthday?
r - august 29th
j - what year?
r - oh, i can't tell you that
j - oh, you can't? well, you graduated...i'm just trying to...
r - 1950: mid-century
j - wow, huh.
r - i'm very grateful, by the way, for being alive, i really mean that.
j - i know
r - in the most sincere sense. i'm probably one of the happier people you'll meet despite what i've seen. and the ultimate gratitude for simply being alive, shrinking away, in a rude impatient world. i'm very happy to be alive and a lot of people don't say that everyday, with or without aches or pains
j - with or without aches or pains. and you have one daughter?
r - 3 daughters - 5, 8, and 10.
j - wow
r - and they're wonderful, creative free-thinkers which is what i want.
j - wow. well, congratulations. here we are. thank you so much for your time.
r - yeah, sure, you know its a pleasure, justin. now just send me the stuff, a hard copy or whatever...
j - a hard copy, yeah, right. i've got about an hour of tape here, maybe a little bit more and i'll give this to someone and they're going to type it up and then i will, um, probably edit it and put it in sequence, put it in articles with amy's photos and then see what comes out of it and i work for this magazine, i'm self-published mostly on the internet but i do this work for these people because its a different venue, broader venue so i think what will probably happen is that selected quotes of the interview, the short digestable chunks will end up on their site and then a couple months later i'll put more of the entirety of our talk
r - which magazine, say?
j - oh, its called electric minds, you got a press kit, right?
r - no i didn't
j - yeah, you did, they said they sent you a media kit
r - do we have an electric minds media kit? maybe i didn't know what that was
s - electric minds what?
j - electric minds media kit.
r - ok
s - uh uh
j - it was a white folder with a, i could actually show you the logo but anyway
r - don't send me another one if you did
j - ok
r - sorry
j - so you do have a problem with paper? what would you say like your one problem is? i mean, you've got your hubris, you got your...
s - keeping his office organized
r - lots of problems
j - keeping your office organized?
s - keeping his office in there, organized. no, i'm just kidding.
r - i think the, uh....i won't say anything. i'm happy to be alive.
j - (laughter)
r - how's that?
j - hey, that's great
s - i could tell you some things
j - well, sure, that's why the interview's over, right? ok
r - tell you the truth, its patients unlike you who don't want to be well and don't want to do well - people with self-destructive impulses who carry it into the office and want me to be mom and dad and take care of them cause they've failed to grow up, individuate, develop identity, heal themselves, stay well and so only a small fraction of patients really honestly want to ask questions you've asked of yourself so what i don't like is people who really don't want to be at their best because they're copping out on themselves in the worst possible way and they're always self defeating.
j - well, do you tell all your patients about your clothes and your pottery and your musical instruments?
r - no, no, no.
j - because...
r - i look into their minds and hearts and try to figure out what they need and what they can handle
j - what they can achieve, yeah
r - that's right. because my way is not the way but anybody can do what i've done.
j - whew. thank you yoda. wow. okay, so i might be in touch if there's a title i can't clarify and if you have any thoughts that, you know. ok, thanks.