The Only 2021 Year-End Wrap-Up You'll Ever Need To Read

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It’s A Tube, Mostly.

If you’ve never had an MRI, it’s not necessarily an experience I would recommend. For one, they’re very expensive. For two, they’re very long and loud. For three, well, I’m not sure why you’d need a third reason.

The MRI machine is a big, plastic tube. It uses magnets to see inside of your body. For people with Multiple Sclerosis, like me, it’s important to get regular MRIs to check for signs of advancing disease. They’re also extremely boring. The tube’s opening is very small, just large enough for a body to be slotted into it. When it’s time to go, you’re strapped onto a board, slid into the tube, and told you have to sit perfectly still.

This December saw my second MRI of 2021, and my fifth overall MRI. I’m likely to get an MRI about once a year or so until I’m so old that Multiple Sclerosis is no longer the main direct threat to my health and wellness. As an auto-immune disorder, Multiple Sclerosis is when your immune system goes haywire and attacks the protective coating around the nerves in your brain or spinal column, leaving little scarred spots. Usually these attacks leave you with pretty drastic symptoms: this January, a flare up cause the entire lower half of my body to go numb for about three weeks. I wrote about that process in February, when my fingers regained enough sensation for me to be able to type.

Medications for Multiple Sclerosis are designed to do one thing: prevent future flare ups. The MRI then becomes a way to ensure your medication is working. Most flare ups, or exacerbations, will lead to obvious physical symptoms. There’s a chance that one could sneak by unnoticed, however. If that happens once a year or so, well, let’s just say there’s only so much brain and only so much spinal column, and it’s best to not let it slowly and secretly become scar tissue.

The medications these days are good, however! Once a month, I open my front door to a cardboard box. Inside the box is a styrofoam box, and inside of that is a dose of my medication sitting between ice packs to keep it cold. When I’m ready to administer my dose, I take the medication out of the fridge, let it warm up for 10 minutes, clean a small patch of skin on the top of my thigh, unscrew the cap on the pen, and jab the spring loaded needle into my leg. What this medication does is eradicate all of my B cells, so that they can’t get all worked up and attack me, instead.

This leaves MRIs as, mostly, a boring event. In order to properly capture images of an area, an MRI takes about 20-30 minutes. The brain is easy to grab in one go, but there are three different sections of the spinal column that need images, so a spinal MRI has you loaded in for 80-90 minutes.

This December, we did a full workup of my brain and spinal column.

So, with that in mind, I’d like to deliver to you this ultimate end-of-the-year list, in case you, too, have to do a full brain and spinal MRI and need the advice of someone to help you pass the time:

The Top Five Songs To Try And Sing To Yourself While In A Lengthy Brain And Cervical Spine MRI Of 2021

1. Paul Simon “Boy In The Bubble”This one seems obvious at first. You know Graceland like the back of your hand. It was one of two albums your dad had on cassette for the car, and between that and Yes’ 90125, Graceland aged a bit better. You fell in love with the album again in high school when Paul Simon’s lyrical style started to show its intricacies. You know the album by heart, why not try and recreate it entirely in your mind? You start by mentally humming the the accordion intro, but you find it’s hard to know when the beat starts to kick in because the magnets spinning around your head are starting to clack super loud. You repeat the intro accordion bit with your mental humming, but eventually you know you need to just starting singing the words. You make it a few stanzas before your lose your place. Is this where the saxophone comes in really loud and shrill? That buzzing is throwing off your rhythm again. You might as well make your way to the chorus. But then after the chorus, what? You can’t remember. You think you’re maybe working into the third verse, but you can’t be sure. The backs of your knees are getting sweaty. They’re propped up by a triangular pillow meant to keep blood flow regular while you have to lay perfectly still. You think you’ve done a decent job, and maybe it’s time to move onto the next song. The MRI technician comes in through the speakers inside the tube and lets you know the next set of photos is going to be six minutes.

2. Paul Simon “Graceland”An obvious second choice. The album flow! We’re going to do all of Graceland. This one is going to go better. This one you’ve sung over and over — you even tried to learn it on guitar! You think doubt your favorite line “she comes back to tell me she’s gone, as if I didn’t know that, as if I didn’t know my own bed” but that’s later in the song. You decide to skip the intro, and figure that working through the music is a fool’s errand. You’re making your way through the verses okay, but you start to worry about that tooth filling you just got. It wasn’t metallic, was it? If it was, the magnets will rip it out of your skull, potentially bursting straight through your cheek. You don't worry long, though, because you realize if it was metallic, it would have already happened. You open your eyes. You see the faint lights on the ceiling of the tube, just inches from your face, but you close your eyes quickly. No need to get claustrophobic if you can avoid it. The technician comes over the speakers and lets you know the next set of images is going to take three and a half minutes. You realize you still have an hour and ten minutes left to go.

3. Paul Simon “I Know What I Know”Well, you did bad with “Graceland.” You gave up mid song. That one was supposed to be the slam dunk. But you’ve already moved onto the rhythmic clacking beat of “I Know What I Know,” which almost matches the time of the magnets clacking over your head. You start to think about how it’s almost Christmas, and how your mom asked if you could make pizza for everyone instead of a normal Christmas meal. There’s going to be ten people. You think back to the summer when you were home, in the middle of your move from Chicago to Madison, and your brother and his wife and their two kids had travelled back from Japan in order to get vaccinated. Things like vaccine rollouts are so orderly in Japan though, you thought. I know, your brother told you, but it’s so orderly that they’re restricting vaccination to only 65 and older, and at that rate, it might be a year before we can get our shots. When they were home, it was seven people in the house that you made pizza for. You made two pan style pizzas, a sort of take on a Detroit style pizza, and one large sheet pan pizza, sort of a Roman style square cut pie. There were always leftovers. But now Christmas will be ten people. You start to juggle the pies in your brain, wondering how you might get more pizza cooking in that one oven at the same time. You mull it over. There’s only room for two cast iron pans. And plus, the twelve inch ones you use for bread baking aren’t well-seasoned: the crust will stick when you bake them off. The well seasoned cast iron pans you have are only ten inches. That cuts down dramatically on the size of the deep dish offerings you have planned. But maybe you can do two sheet pan pizzas. Or even better yet, you’ve often made a simple potato topped al taglio pizza as an appetizer for when you do the hi-temp traditional pies, It’s great to have on the table to snack on at room temp while guests arrive, and since those pies bake off so quickly, you don’t want to fire them until everyone arrives. You can do three sheet pan pizzas: a potato pizza you bake off early, then you nail two red sauce pies, and while those are cooling you can toss the potato pizza back in the oven for a quick what have you. That’ll feed ten people. But then you think about holiday travel anyway: is it responsible? Your aunt and uncle are flying in to stay at your parent’s house, and then it’s your cousins and your aunt and your second cousins… can all of them gather safely? Even with a negative rapid test right before entering the room, is that enough? You have to be careful. You’re on immunosuppressant drugs. You think about Japan, and it’s strict masking and distancing and travel rules. You think about how well those managed the original COVID-19 outbreak. You think about how safe Japan must feel with a high vaccination rate and strict societal rules. You remember how your brother texted you about how his family went to the US Army base so his kids could finally eat at a Chili’s for the first time, as a lark. You think about how you haven’t eaten inside of a restaurant in almost two years. The technician comes onto the speaker to tell you the next set of photos is only four minutes.

4. Bruce Springsteen “Born To Run”You try a song one more time. It’s not easy. The backs of your legs are very sweaty. You’re not really sure how long you’ve been in the tube. It might have been only the length of a few songs, but maybe you wandered off a bit more. Maybe you didn’t. You try to remember how the intro goes with Ernest “Boom” Carter’s amazing and electric drum fills. You think about how Boom got the short-end of the stick when he and David Sancious left to form a jazz fusion band and Max Weinberg got the full time E Street gig. Weinberg is great on the backbeat, but nothing could quite capture the freewheeling loose intense joy that Ernest “Boom” Carter nailed on “Born To Run.” Maybe that’s enough to think about, maybe you don't need to try and recreate the song in your head. The clacks and buzzing are so overwhelming that it’s hard to hear yourself sing through them, but you can form distant thoughts. You can let the MRI rhythms and tones create white noise maybe for some wandering meditation. Pizza has got you thinking about bread, and how much joy you’ve found lately in your baking. You’ve really nailed your processes down and your breads are photo perfect and taste amazing. You even have your preferred flour blends down pat. You visualize yourself working the dough with your hands, blending the flour into the water and cutting it in with little pinching motions. The more you squeeze the more you feel the dry pockets of flour suck up the water squelching inside your palm, and when you release there’s a new paste being formed into a dough. After you mix it, you give it time to settle and hydrate. This is called the “autolyse.” You’ve never looked up where the word comes from or what it means. That’s okay. You do it twice a week, though. Autolyse. Lees? Lies? Auto-lies? Auto-lees? You’re not sure. You can look it up when you get home. The technician comes over the speakers to let you know there’s only four more images of your brain, and then she’ll pull you out for a break and start on your spinal images. You’re halfway to being a quarter of the way done.

5. Andrew W.K. “No One To Know”What’s a song you know? What’s a thing you even like? You think that maybe this could be an end of the year list thing. The only album of 2021 you even listened to was Andrew W.K.’s new album. Andrew W.K. and his ex-wife started divorce proceedings in 2019, and in 2021 he released his absolutely phenomenal divorce album God Is Partying. It’s the first time that Andrew W.K. fully embraces the darkness and heaviness of heavy metal, a genre he’s always flirted with but never fully embraced. The third song on the album, however, is a slow building ballad. You’ll hear the opening piano start to echo itself in octaves and remember that Andrew W.K. is a classically trained pianist. You’ll briefly try to remember the name of that one fully improvised album of classical piano he released somewhere in the mid-00’s, but it doesn’t matter because you didn’t listen to it anyway. The lyrics kick in, and you think “ah, those are interesting” and then you’ll remember it’s a divorce album so you can apply more depth to them with context. You’re also divorced. He sounds sad. His singing voice is actually pretty powerful and he’s actually working a decently complex melody. You’ll think about how there was that one time that Andrew W.K. officiated your friends wedding. You’ll think about how he was extremely nice and very normal, and whenever someone asked for a picture with him, he’d nod enthusiastically then stand up, flip his hair a bit, and then get fully into character for the photo. You met his ex-wife there. She was nice. You’ll remember that you attended that wedding with your own ex-wife and now wonder if you have something new to talk about with Andrew W.K. the next time you see him. You didn’t talk to him when you were in the elevator with him at the hotel because you didn’t have a subject to start on, but you do still have a good hotel elevator story from that weekend, because Bone Thugs ‘N Harmony was also staying at that hotel and your ex-wife was hit on by one of their crew members in the elevator and got invited to a big afterparty that Bone Thugs was throwing. You wonder if Andrew W.K. knew Bone Thugs was there, and if Andrew W.K. just plainly knows Bone Thugs. That would be cool. I bet he’d be able to get along with them well. He also knows a lot about music, so I bet he’s actually a pretty big Bone Thugs fan. You wonder how Andrew W.K. copes with being famous and going through a public event like a divorce. He recently deleted all his social media presence. That can’t be good, right? But then you remember that he’s now engaged to Kat Dennings. And that they seem really happy. She’s even posted a photo of them together that was taken after he deleted his social media. That’s gotta be a good sign. You also remember that when you go home, your girlfriend will be waiting for you. She’s the one who cared for you after your own divorce, and she’s also the one who cared for you when you were first diagnosed with MS. You were in the hospital for optic neuritis, and a friend of yours who is a doctor was texting with her letting her know it was likely MS, even though your doctors wouldn’t diagnose you for another year and half, when you had your first mobility limiting flare up. You remember when she came to the hospital, and told you all about how it was going to be okay. That MS was treatable and that she would be there to take care of you the whole way through. And you remember laughing a little and saying “Wait, do you think I have MS? I don’t have MS!” And you realize that she had spent the whole weekend researching MS for you. You think about that moment, a year a half later, when your own doctors finally get your diagnosis correct. You think about a way to make it funny. When she gets home from work, you look her in the eyes and say “You know what, my bad for lying to you.” “Lying about what?” she’ll ask. “Well, about a year and a half ago, in the hospital, I laughed and said I didn’t have MS. I guess I lied.” She’ll laugh, but she doesn’t think it’s that funny. It’s the absurdity of the moment, the tension break knowing that all your debilitating symptoms of the last few weeks now have a diagnosis and a treatment program. You’ll remember those moments, and you’ll remember her love and strength and how it carried you through it all. You’ll think about her waiting for you at home while you’re in that MRI, and how these things are so common now you just drove yourself to the MRI. You think about how she’s cooking you dinner, and how she cooks dinner for you both most nights, and how it’s just one little way she shows you how she cares. You know that with her support, you could get an MRI every week and be okay. The technician comes on the speaker and lets you know it’s time for a break so they can reconfigure for your spine. The table starts it’s motorized hum and your slowly slide out of the tube. The lights are much brighter in the room. The unhook the plastic cage over your face. First one down, just four more to go, now. Time to start thinking about some other songs you remember.

Artwork by Ashley Elander Strandquist. You can view her illustration work here and check out her printing business here.