The Challenge of Pain

512px-Antoni_Madeyski_-_Ból

Two years ago I suffered from nerve pain of an uncertain cause: excruciating discomfort below the right side of my rib cage, like a burning cigarette against my flesh. I could not sit for more than a few minutes without a growing conflagration. Trying to sleep on my back delivered the same distress. I spent every day and night for a month standing or on my side. Upon making my return to a humanities class I still had to remain upright for long periods on the commuter train, with frequent episodes in a vertical position in the seminar room. Eventually, medication eliminated my symptoms and life went on without ever knowing for certain what caused the problem, even after extensive testing. I’m long past the treatment and the pain, but my experience was a trial.

I cannot draw parallels or contrasts. Not with you or anyone else, except those who suffer worse for far longer. Too many of you, I know. At the time, however, such knowledge counted for little. I lacked a yard stick to measure the combination of severity, the fraying of the soul, the psychological darkness, the difficulty of passing the minutes without counting the time, the presence of a thing I didn’t understand and couldn’t will away. The worst part? Not knowing if the unseen torturer had plans to leave.

As I mentioned, the most acute stage of the process lasted a month and over two months passed start to finish. The physicians were excellent. One idea persisted: not fear of death, but a life of endless illness. I would be ground to little bits like flesh subjected to mortar and pestle.

Pain tests you. You are asked what you are living for. The longer the pain, the greater the uncertainty of its duration, the louder the question.

Time stretches, food becomes a necessity — not a pleasure. Some folks you tell, others you don’t. The best of those informed remain concerned and supportive. A few disappear, usually to protect themselves from your travail and their fear of contagion; contagion of your distress or, just as often, the idea something else will target them.

Illness does not wait until all else in your life is ready to take on the burden. Issues with which you are struggling pile on, like a football team that’s already tackled you and enjoys the thrill of seeing how many bodies can be stacked on top of your own.

Joy flees, laughter is brittle — a momentary distraction. The “tough guy” images on TV don’t help, but suggest everyone else is more durable. The future — imagination of time ahead that would normally give anticipatory pleasure — slips away. All you want is relief. You work to hold on to your self, the one who prided himself in taking on difficult things, facing people, being a man. Self-image alters. Perhaps you are not who you thought you were; or perhaps you were that man, but are no longer.

You lack control of what is outside and what is inside, all except your response. The messiness of the world you thought you organized is evident, like carefully arranged blocks now scattered beyond reach.

What do you hang on to?

For some it is future plans, jobs to be done, achievements targeted long ago. Gratitude for what you still have is a mental weapon pitched at the physical giant set against you. Meditation can be a salve, but only if you are already an expert.

I had an uncle who was so into technology he wished to live to witness how men might change the world. I know of a former patient who stays alive because almost her whole family died in the Holocaust. She will not give away by choice the thing taken from them without choice, no matter the suffering she endures.

512px-Madeyski_Pain

Perhaps you reframe the challenge before you as a test, the way a Stoic philosopher would. They thought pain was something unremarkable because such a time comes to most of us. Greatness, they say, is the product of the bravery you show only when events turn against you, not on the sunny days.

God can figure in, though individuals so sustained would not all give you the same definition of the role he plays. Then there are people toward whom you feel love and responsibility. You persist because of what they mean to you and what your absence would do to them. Made aware of the extent of your distress, they offer support and love more strengthening than water and food.

If, like me, you are lucky, the crisis ends. You recall it, but as an idea, not a sensation. Now, however, you are different. It is time to make sense of what happened, who you have become, and whether you wish to live in the same way, with the same values and expectations as before. You did not predict your response to the pain any more than you predicated its onslaught. One day you were fine, the next day you were not.

My friend Rick wrote a profound comment to my last post: “these are emotions we are normally unfamiliar with until the event happens, and so we do not know how to deal with them.” The surprises of life, especially when they are as terrible as he described (the suicide of his mother), leave us unprepared. Moreover, they can cause us to redefine ourselves. Those who act heroically or stoically perhaps think better of themselves. More commonly, however, we struggle with the blows life delivers and our self-image also becomes one of the casualties or, at least, one of the personality characteristics transformed by our bout with suffering. Perhaps the pain provides an opportunity to grow, but if so, without a guarantee.

You have been marked. Remember, though, that in the Hebrew Bible, there is also a story of being marked. Cain murdered his brother Abel, for which he received the “mark of Cain.” This, however, was not to harm him, but God’s warning to stop those who might wish to punish Cain for the crime.

For the rest of us there is no such indelible symbol evident to the world. Whether God has used a different way to safeguard you is for you to say. For myself, however, I was lucky to have a sustaining love and enough will to keep going. Objectively, the time was short, however much it seemed endless.

True, I know more about human frailty and my own limitations now. I think I am more humane, but do not think me a hero. I wouldn’t have chosen the ordeal had I been promised some great reward for my persistence. Nor would I volunteer for such “learning” again.

We are clay and sculptors of that clay, both at the same time. Its final form, however, is not our work alone. Unseen hands offer their careful, kind, or calamitous touch.

The photos are of the sculpture, Pain by Antoni Madeyski. The first of these was provided by A blakok. Both are sourced from Wikimedia Commons.

 

 

11 thoughts on “The Challenge of Pain

  1. ‘medication eliminated my symptoms and life went on without ever knowing for certain what caused the problem, even after extensive testing’ Ah, ain’t Allopathic medicine great….supress Not cure. ..Get thee to an Osteopath that does Manipulation, Dr S…ALL will be revealed.

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    • The MDs had some hypotheses about what was causing my pain. In the absence of definitive test results, they pursued the most likely of those and their ministrations gave (ultimately) complete relief. Short of recreating my condition prior to treatment and doing an experiment that would reintroduce my pain so they could see if the treatment would again relieve it, there was no way to be certain their approach was what made the difference. I have never met any healer with all the answers, whether an osteopath, an acupuncturist, an MD, or a psychotherapist. I’m glad your treatment has been useful for you and hope your good fortune in seeking medical advice continues. I am also grateful for the help I received.

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  2. Its hard to when the pain you experience is emotional. There aren’t really any tests that can be done to find the problem, no surgery or procedures, or medications. They can do joint replacements like the hip and knees to relieve the pain but not brain replacements to take away the mental distress. Therapy can be a very long term and expensive endeavour that is a painful process in itself particularly when the emotional damage is severe.
    There are things that do help though, getting knowledge that changes your perspective may not change your situation but changes your attitude, the kindnesses of other people that let you know that you are seen, the example of many others who have endured and triumphed against the odds, having gratitude despite the pain for the small blessings that come each day. And yes, for me, the knowledge that God will give me the strength needed and will walk with me each day, knowing that I will never be on my own all bring me comfort that helps me to cope.
    And as your post has done, let me know that others know and understand the challenges that are faced. Its a huge comfort to know that I’m not the only one, its one of the reasons we are drawn to sites such as yours because it connects us with our own experience. Its one of the best medicines in life isn’t it, just plain human connection. Thanks again Gerald reading your post has just relieved some of my pain.

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  3. That this has been helpful in a small way is gratifying, Claire. It was my aim in writing this particular piece in as frank a way as I did. Thank you.

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  4. Pain is another one of those human challenges that I just don’t get. What’s the point of it? Why is it here? I know, I know, it’s all a mystery but I am angry that life is full of such challenges. I repeatedly ask myself, “What’s the point of any of it?” and have yet to hear an answer.
    For most of my 60 plus years, I have been remarkable healthy with only a nodding acquaintance with physical pain. The last five years have brought a collection of orthopedic issues and much big pain. But, even in the midst of those painful days, I would remind myself that (presumably) I was on a healing trajectory. There have been days (and continue to be days) when I wonder if I will ever be pain free again but I chastise myself with that reminder that my pain is (in theory) not permanent and that it is not attached to a debilitating and progressive illness. I am the lucky one! So far….
    Emotional pain? A different story.

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    • JT, I once worked in a hospital. A doctor told me that pain was the body’s way of signalling that something was amiss. Silent, pain-free, body killers give us no recourse to pro-active treatment for an extended life.

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    • You’ve asked the oldest question of all, JT. I consult the philosophers and am still unsatisfied. We are hardly alone in this, but we make the best of it. With luck we get our share of good luck and concentrate as much as we can on what good we can do. Perhaps the bad is then a bit more easily accepted.

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  5. Thanks for another soul-searching post, Dr. Stein. I think that a woman’s relationship with physical pain may be somewhat different from than of our male counterparts. After all, for many women, like myself, we experience pain at an early age and at regular intervals with our menstrual periods. Then, when we reach childbearing age and become mothers, there is labor pain. Of course, some pain last for longer periods of time and may be more intense.

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  6. I cannot disagree that women are the hardier of the genders. I did, however, have one especially interesting comment on the question of childbearing. I treated a nurse who told me that she had experienced both the pain of having kidney stones and the pain of bearing children. Without prompting from me, she said that in her experience the kidney stones were tougher. I’ve had the latter, but, of course, no children who passed through my body. Still, this is what researchers call a “small sample size” (the nurse), so I dare not say anything more that might suggest women have it easier. I doubt they do. Thanks for commenting, Rosaliene.

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  7. With debilitating PTSD and cervical pain, I always cite my intelligence and sense of humor as the two blessings that keep me going.

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