A Heartache Coping Strategy Based on the Evolutionary History of Hiccups – Marginalian

Long before he became the world's most popular neurologist, Oliver Sacks was a twenty-seven-year-old medical resident on his first job at a hospital when an operation left one of his patients with an uncontrollable hiccup. Already a person on the bridge between medicine and literature, he found himself haunted by a short story by Somerset Maugham about a man who dies of constipation after a woman bewitches him. Fearing that his patient might face the same fate without something to jolt his brain into a spasmodic loop, Oliver suggested something drastic yet emblematic of what would become his lifelong gift for synchronizing physical activity and mental poetry: to deliver a hypnotic. His colleagues were skeptical bordering on contempt. But the patient has been in shock for six days straight and no medical intervention has worked. Oliver recounts in his book which is better than a memoir:

To our surprise, he was able to put the patient “under” and gave him a posthypnotic command:

“If I snap my fingers, you will wake up and have no more hiccups.”

The patient awoke, free of hiccups, and had no recurrence.

Why a strange psychological intervention is so successful in alleviating this debilitating evolution of the body, and how it constitutes a highly effective strategy for awakening from the depths of heartache, is rooted deep in our evolutionary history.

A hiccup is an involuntary sharp inhalation of air as the epiglottis – a flap of skin at the back of the throat – closes, producing hi a sound called a spasm. As our limbs carry the genetic blueprint for our dorsal fins, just as our tailbones hold our ancestors together, hiccups remind us where we came from. Although our basic neural infrastructure for respiration evolved from that of fish, hiccup's distinctive pattern of nerve and muscle function is inherited from the tadpole stage of our aquatic ancestors. Tadpoles use both their senses and their lungs to breathe, pumping water into the mouth and through the lungs but keeping it from entering the lungs by flapping the glottis to close the windpipe – one long hiccup.

While our bodies evolved beyond recognition from the tadpole, our brains retained the neural circuitry for this dual process – presumably, to help nursing infants manage breathing and feeding simultaneously. The genital organs of human embryos no longer exist in most adults, but the neuroanatomy of the bent breath remains and is triggered by certain stimuli to cause hiccups – eating too much or too quickly, drinking carbonated drinks, exposure to rapid temperature changes, severe stress.

That's why, despite the panoply of folk remedies and pop culture myths to stop hiccups, from backbends to biting into a lemon, the most effective way is to simply reset the brain out of its evolutionary time machine by making a more complex demand on its neural circuit. (For me, doing a little calculus always stops a hiccup spell.) While physical interventions like controlled breathing can sometimes help, it's more the mental need they do with the focus they need to interrupt the spasms.

The irony of the human animal is that although we have not yet fully eliminated the physical remnants of our evolutionary heritage, we have paid a heavy price with our increasing mental complexity. (“Never say higher or lower,” Darwin wrote in the margin of a book of natural history, arguing with the author about the so-called higher animals. “Say more complex.”) As we left the sea and crawled to the earth, then we climbed the trees to learn to live with other people, then we returned to the ground to walk straight under the plate of a billion creatures, which made us able to lose a hundred billion, which made us have the power of billions of love. it is the value of consciousness.

The experience of heartache – the repetitive mental breathing that is no longer available, or perhaps never really existed – is an emotional hiccup: a thought that feels involuntary, interferes with healthy functioning, and causes a debilitating discomfort that you can't get rid of. Like Oliver's patient's constant rumination, it can only be alleviated by mind-switching – by putting the mind on a different path of focus that requires its own resources to break the rumination loop. It doesn't matter what it is – starting a new exciting project (this is what birdwatching did for me), learning a new language or a new art (this is how ceramics came into my life), training for a triathlon or taking up the cello or going down a fun rabbit hole about the impossibility of bats or the invention of the bicycle or chemistry i blue I Traversal). The important thing to remember is that all emotions float on a current of thought that runs through the brain at eighty feet per second. Divert the current energy and the emotional charge dissipates – perhaps not to complete neutrality, but to something bitter and bearable, like a childhood memory, as if the body remembers its bones.