Chapter Fifteen: Hungry, Hungry Maggots

Despite what their seemingly insatiable hunger for household and bodily wastes might suggest, flies can be remarkably picky eaters. In their infancy, still wriggling around as rosey-cheeked maggots, there are some that will sooner die than eat dead flesh. I suppose it makes sense—I mean, everybody’s got their standards. Even if you’re on the dog poop diet you’ve still got the right to say cadavers are a dealbreaker. The one that really gets me are the species of larvae that eat dead flesh exclusively. The tenderest, juiciest, bacon-est pig could die suddenly at a farm and there are species of maggots that would lie on top of it writhing in the throes of helpless starvation because it was too fresh. How did this come about, exactly? Did their ancestors just get so sick of getting smacked and swatted at that one day they gave in and settled for rotting meat? All so that they could finally enjoy a meal in peace? Is there really no turning back from that? Is that an acquired taste worth passing on to your kids? You gotta be kidding me. These maggots must grow up to be the flies that headbutt a windowpane a million times even though it’s wide open a few inches away. We’re talking about larvae that devour dead flesh like it was movie theatre popcorn and hit the brakes the second they reach healthy tissue. Incidentally, we know this because doctors use them for that exact purpose.

It’s called maggot therapy. The long and short of it is that, when you’ve got a wound with some necrotic tissue, you cover the area with maggots, wrap it up in special gauze, and then try not to think about it. (Suddenly, not thinking about a polar bear seems like a cake walk.) Let the lil’ guys nibble away for a couple of days and then you’re good to go. They don't have teeth, and the enzyme they use to eat is ineffective on living flesh, so they can't harm you no matter how carried away they get. If your wound is really sensitive and you start to feel the creepy-crawly squirmy-wormies, you can just swap them out for younger, smaller ones. Not only are the maggots much more precise than any scissors on the surgeon’s tray, they also take way less expertise to use and pose virtually zero risk of misuse.¹ But wait, there’s more! Researchers have discovered that these maggots can also disinfect a wound, prevent infection, and even stimulate the body’s own healing process.

The incredible healing powers of these maggots were actually discovered hundreds, maybe thousands, of years ago. The only problem is that we can’t seem to break this cycle of discovering the incredible healing powers, forgetting, rediscovering, forgetting, and rediscovering. The trend can’t manage to stick. Over the last couple millennia, the conversation seems to have remained more or less the same:
“Hey, we can cure that nasty flesh wound for you.”
“Hooray, it’s a miracle!”
“We’re just gonna go ahead and stick some maggots on there and in about three days it’ll be perfectly healthy.”
“Pardon me, did you say you’re going to use magnets?”
“No, they’re maggots. Little larvae.”
“Ok, great, why don’t we give those magnets a shot.”
“Maggots. All we have are the magical healing maggots that carry no inherent risk and work perfectly every time. It’s either this or the rusty manual bone saw.”
“Well, since the bone saw is my only option I guess we have no choice but to amputate.”
“But what about the magg—”
“Lalalala, I can't hear you!”

There is no question that if you could get these kinds of results from a pill, it would be as ubiquitous as penicillin and morphine. Unfortunately, the thought of filling a wound with maggots (albeit lab grown, sterile ones with magical healing powers) is so disgusting that the scientific community keeps pioneering and re-pioneering the treatment only to have it filed away under nope nope nope. Lately, there seems to be a renewed and growing interest, yet it still remains very much on the fringes.

Part of what makes science so effective is its objectivity—its loyalty to the evidence over everything else. Cases like this one—and there are many—are reminders that science is not immune to human error. I’m not saying we should scrap systematic thinking and go back to sacrificing goats, just that it’s a little premature to declare science a finished project. This is the system that put a rover on Mars, put AIDS in a chokehold, and put supercomputers in pockets, but it’s not impervious to a rebuttal like “yeah but… maggots though.”

Now, the wounds on my leg were made by a surgeon with a scalpel in an operating room, not a villager with a blunted claymore in a muddy field in 15th century Scotland. Debriding my fasciotomies with maggot therapy would have been incredibly beneficial, but it also would have been overkill when there were more pressing procedures at hand. I never received the treatment, but it's something that has resonated with me ever since I first learned about it. As I read about it, so much of the story felt familiar. On the surface, it's hard to imagine a more dissimilar therapy to the one I did with my dad, but the two have a lot in common. One uses worms, one uses words, but they're both natural therapies that, despite working amazingly well, are met with skepticism, wariness, and closed-mindedness.

Of all the potential allies that the medical system can co-operate with in treating the human body, the greatest and most important is the human body itself. This is what my father taught me. Almost every day, he would pull a chair up to my bed and talk with me for twenty or thirty minutes. He worked in another ward of the same hospital, so he often visited after work. Whenever he couldn’t see me in person, we would talk on the phone. He has the deep, weathered voice of a cowboy sheriff who could tame a varmint or disarm a bandit without unholstering his six-shooter. He has a bassy growl with just a hint of grit in it—the kind of voice that could never be used in a GPS because people would make wrong turns just to keep him talking. You could record him reading the warranty info on the underside of an old lawnmower and people would mistake it for a Cormac McCarthy audiobook. He is also a seasoned psychiatrist and someone who has loved and moulded me since birth.

I'm telling you all of this specifically because it doesn’t matter. There was nothing complex or extraordinary about our conversations. The brain is complex. A father’s love for his son is extraordinary. The rest is simple. It takes a special mind to even begin to understand it and years of experience to appreciate the scope of its strength, but the treatment my dad gave to me is something that anyone can use and benefit from. The body is built to survive and the brain already knows how to run the show. That healing power belongs to you; it's yours to use. All my dad had to do was remind me of that. When we spoke, he would guide my thoughts to my body, helping me clear my mind, slow my breathing, and relax my muscles. Then, he would talk to me about how my body was healing—everything it had done to allow me to survive, and everything it was now doing to rebuild me.

The first night, on the way to my fasciotomies, there was hardly a moment for us to talk, but all it took was a moment. There’s always time to get ready. “This is an emergency situation and you’re going to have some emergency surgery,” he told me. “Your body is going to need some help here to start the recovery process.” Dad told me to trust the doctors and trust my body. And I trusted him.

In the days following that first surgery, we had a lot more time to talk. Sleep was so fleeting and fitful for me then that the relaxation I got from our talks was often the only way to get some rest. We did sessions at every opportunity; almost every evening and the occasional afternoon as well.

Dad and I talked at length about my second and third surgeries—the doubleheader with the internal fixation and the skin grafts—on the days leading up to them. He demystified the procedures and made them normal. He helped me understand what was coming: my leg was going to feel different and I was going to experience a lot of intense sensations, but it was going to help my body to heal. Coming into the operating room with the right mindset was essential because, as far as we’ve come, our techniques are still primitive. The scalpel is a very crude instrument; on the cellular level, it’s like trying to cut pizza with a two-by-four. On its way to its destination, the scalpel enters the body like a bulldozer through a flower patch. Dad helped me to accept that in order for me to heal, the bulldozer had to come in and when it did there was going to be collateral damage. Giving in to anxiety would cause my body to tense up and resist the scalpel, which would be like building a little white picket fence around the garden. All that’s going to do is leave a bigger mess when the bulldozer comes. The collateral damage was non-negotiable, so the best thing I could do was to get ready and prepare myself to receive the scalpel without a struggle. Calm and confident. Acknowledging that the surgery was going to do some damage didn’t have to be scary because it was all stuff that the body could repair.

I spent so much time dwelling on how fucked up I was that I often forgot that I was surpassing everyone’s expectations. I wasn’t just recovering well, I was making an anomalous recovery. Every day, my dad talked about the body’s incredible ability to heal itself and every day was more proof that he was right.

One of the most crucial steps in learning to trust my body was learning to stop distrusting it. We grow up being hounded by messages to buy this pill, this cream, this treatment, and end up feeling like we’re helpless without them. Somehow we conflate the power of medicine with the weakness of our bodies, which couldn’t be further from the truth. Our brains were in charge the first time around, building our bodies from scratch in the womb and, lo and behold, we turned out just fine. The brain does a marvelous job on its own, and even better with a little help. Really, is it that hard to fathom that the brain could repair something that it built in the first place? My dad’s treatment didn’t teach my brain anything new, nor did it unlock some secret mystical power buried in my subconscious. All it did was make me mindful of my brain’s role and relax me so that it could do its thing—and that didn’t mean turning my back on the hospital’s methods. The brain and the healthcare system perform best when they work in unison. There was no reason for my faith in the doctors to undermine my faith in my brain’s ability to do what it does best. They’re two horses pulling the same wagon—trip one and the other’s got to drag it.

One of the reasons why I benefitted so much from my dad’s treatment was that I was already familiar with it. Mindfulness is a skill that you train with practice over time and my dad had been helping me develop it since I was in kindergarten. We used it to help me relax before big exams or important hockey games so that I could focus on doing my best. We used mindfulness to help me when I broke my wrist as a teenager too—little did I know, we were practicing for something much bigger 7 years down the road.

Because I grew up with it, it never seemed strange or dubious to me; I was well acquainted with the process and its efficacy before I got old enough to pick up skepticism or misconceptions. People who are unfamiliar with it might picture it as this spooky, paranormal wizardry when it’s anything but. They overestimate how weird it is and underestimate how much of a difference it makes.² Call it mindfulness, call it faith in biology, call it faith in God, call it hypnosis, call it whatever you want, but it only works if you trust that it will. Day after day, half an hour at a time, my dad helped me restore my confidence in my body. It had an essential part to play. That was the message to my brain: we need you. We need your involvement.

The brain is a phenomenal healer and—actually, that’s it. That’s all there is to say.
The brain is a phenomenal healer. Even better than maggots.

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