3 ways to deal with PEM, a lunatic guide
June 9, 2026
PEM is post exertional malaise. Also known as a setback. Also known as a steaming Pile of Excrement Monsters.
It is the body's reaction to overdoing it when you have a chronic fatigue condition. It involves bonus fatigue, usually accompanied by an absolute orchestra of extra symptoms. Instruments in this orchestra may include dizziness, aches, insomnia, brain fog, hypersensitivity to stimuli, plus a huge range of bonus options.
The music is pretty crap.
There are no shortcuts or get out of jail free cards, you just have to get through it.
My current round of PEM is on day 14 and shows no signs of letting up.
What is helping me this time is, once again, the small things.
1) Follow a chain of thought past any reasonable or natural conclusion
I found myself out of position next to the bookcase. I don’t really know where I was going and it seemed like a whole lot of effort to move anywhere so I just kind of chilled out on the rug for a bit.
I decided to pick out a book because why not? The book I picked up was The Greenwich Market Cookbook.
Years ago I was wandering around the local market (disgracefully) failing to appreciate my ambulatory power. I noticed a table covered in free recipe books. No one was monitoring it. There was a printed sign next to a huge stack of books reading “free recipe books, please take one.”
I looked around and picked up a book in the most unnecessarily guilty way possible. So much so that stall holders gave me side-eye all the way out of the courtyard. I don’t know why I couldn’t accept the idea that this recipe book could be free. It just seemed unnaturally lucky. After briefly scanning it once, I never opened it again.
The first recipe in the book is chipotle pomegranate chicken quesadillas which involves, amongst other things, pomegranate molasses. It sounds great, but utterly unachievable.
I decide to look up pomegranate molasses on my phone because why not (never crawl anywhere without a search engine).
Well the obvious link to pomegranates is the whole Perspehone/Hades debacle. In Greek mythology, Hades tricks Persephone into eating pomegranate seeds, thereby ensuring that she is bound to return to the Underworld to be his wife for half of every year. A quick search sends me to John L. Myres book, Persephone and the Pomegranate, which has a slightly different take.
Manipulation and consent issues aside, it is hilarious to imagine someone offering you a piece of fruit and then rubbing it all over their face before handing it to you. No thanks.
However, this does lead me onto the only other significant other in Hades life, Cerberus. This is the three headed dog that guards the Underworld in Greek mythology. Adorably, this word may come from the Proto-Indo-European word k̑érberos which means "spotted." So Hades dog was called Spot.
My research takes me down a random side path to musical versions of the beloved hound. I click play on Flipron’s album, Biscuits for Cerberus.
The first song is called Cerberus is as Cerberus Does. The lyrics are indeed, spot on.
Cause he's a sociable beast & his heads all sing:
"We like sniffing the air!
We like biscuits and bones!
We like to bark a friendly welcome as the dead come home
& we don't like being left on our own, all alone, oh no!"
Nor do we. Being on our own sucks, Cerberus, we hear you.
It’s a short step from Flipron to learning about the first ever dog biscuit, made by James Spratt in 1860. It was known as the Meat Fibrine Dog Cake and it was made out of wheat, vegetables, beetroot, and prairie meat.
TBH, I've eaten weirder things while in this state.
James Spratt was a pioneer in three things in his life, lightning rods, dog biscuits and the patented “Spratt’s Improvement in Hermetical Sealing.” You can’t blame him for being too singularly focused.
I decide to bring this ramble home and land on my final stop, a short and unverified news article about Ceasar Beltram, an incredibly unlucky man who, according to the Bay City Times, 1927, was struck by lightning five times.
So I’ve taken a walk from pomegranates via three headed hell hounds out to lightning rods.
That was thirty minutes well spent. Or spent anyway.
And they say having an attention span is an advantage!
2) Watch something so genuinely ridiculous that it rivals your own reality.
TV can be good medicine during PEM, if you can handle the screen.
And a bad movie is an absolute asset. Whether I end up throwing popcorn at the screen, ranting at the main character in my head with a detailed list of their mistakes or just choosing my best rant buddy and typing “CATS. NO” at them until they ask me to explain. If I'm working out all the reasons why M. Night Shyamalan should not have made The Happening, I'm not listing all the ways in which this bout of PEM is (maybe) forever. That's a minute well spent.
Alternatively, like me, you could double down into thinking about the rules of the wider universe which is often excellent value comedy.
I choose John Wick 3, Parabellum.
This film is a vehicle solely built for the purpose of allowing us to watch Keanu Reeves shoot 94 people (the least of any John Wick movie to date). John Wick is an excellent PEM movie for a couple of reasons.
Firstly, you can play the drinking game and have a swig of water whenever John shoots anyone, which is great for hydration.
Secondly, it makes so little sense that it feels like a fantasy made up by a tuckered out five year old who has watched too much Robocop (hello 90s).
That’s kind of relatable.
Today feels like waking up in Bad-Narnia written by that guy who did Magnolia (intense, endless deathbed scene, sudden violent rain of frogs) while on a bad trip.
It’s nice to visit a world that is operating on the same crayon logic as real life seems to be.
I’ve said before that my favourite scene from this film is the one where John Wick has to show fealty to a character called “The Elder.” A small table is brought out with some tools on it. With no guidance or explanation, John proceeds to lop off his finger. I love the bananas logic of a world in which someone would just know to do this. This is a world in which everyone is an assassin (everyone, there are no other kinds of people), there are 500 rules that everyone knows guiding behaviour at all times and travel directions to someone's house include instructions like “walk out into the desert until you collapse” instead of Google Maps.
So I like to imagine the other traditions and idiosyncrasies of Assassin Planet. How do they do Christmas? Is there a training school for assassin dogs? If everyone is an assassin, do knitting circle assassins have a special martial art around their needles? Has an assassin baker ever completed a contract using an icing bag?
Other films that have such huge plot holes that you can climb inside them and build a nest while speculating about a ridiculous, unreasonable universe that (for once) doesn’t affect you?
Transformers (any of them)
Planet of the Apes (any of them)
Armageddon
Remember, it's not supposed to be high quality. It's supposed to be as stupid as this is, if that's even possible.
3) Rebel…with a glue gun
When the shit hits the fan and everything is against us, it can feel really unfair. Especially since we did basically nothing to deserve it. PEM doesn’t show up because I went out dancing on a table all night. It showed up when I did 1% more than I usually for a few minutes. It then sticks around for days. Minimum.
The ratio on crime and punishment here is shot.
I'm pissed off.
I deserve a bit of rebellion.
But there is surprisingly little rebellion on the menu when I can’t go anywhere, get upright, or even stay awake for very long.
A lot of us are on specific diets for a reason. Alcohol and ice cream are a low stakes way of throwing the toys out of the pram unless they immediately make everything worse.
Rebellion isn’t fun if it doesn’t provide at least an hour of feeling smug about it.
Sometimes I don’t even want to rebel, I just want to change something, take an action, make something happen.
Glue guns are excellent tools for making something happen. They’re rechargeable, so I can keep it by the bed or the floor (wherever I end up), they heat up quickly and I can stick just about anything to anything else. Glue a penny to the underside of a book case or a lego figure on the surface of the ceiling.
It’s an incredibly low stakes way of watching the world burn.
Life decided to (literally) sweep your legs out from under you? Punish it by glueing shit to other shit. It’s your home, why not wreck it in the most bizarre and subtle way imaginable?
When I’m feeling at my most crap, not able to sleep, not really awake, trying to figure out what the next step is, with zero focus or commitment to anything, this is a go to activity that feels satisfyingly transgressive without actually achieving or changing anything in a serious way.
These small, ridiculous things won't fix anything, or speed up recovery.
But the small, ridiculous things are important.
They remind us that three headed dogs and pomegranate molasses and men who get repeatedly struck by lightning are part of the picture. This means that the picture cannot simply be the story of "how we fell down and never got up again" because those elements wouldn't make sense in that story.
They remind us that the universe is ridiculous and that we have the power to meet that ridiculousness. We can think about it, throw popcorn at it, glue things to it, laugh at it.
We're still in this, if only in a small way.