When you talk about pain to a medical professional in the US, you’re asked to rate it on a scale from 1 to 10. I’m bad at this. Most of the neuroses that I vest in writing stem from the impossibility of bridging the gap between Self and Other, translating the subjective into the objective. I don’t know what Pain 5 is. What’s Pain 5 for you? If Pain 10 is the most pain I can possibly feel, would I even be able to fill out this form?
They booked me for an MRI on the day I decided it was an 8. The MRI tech cautioned me the machine was “wicked loud,” so he set headphones on me and asked what kind of music I like. “Classic rock? Heavy rock? Alternative rock?” The latter, please. Laying still and focusing on breathing is a skill I’ve worked on, so the scanning process was loud and weird but not too grueling. They gave me the CD of images and told me to make sure I brought it with me to any future doctor’s appointments. This felt picayune, but I’m told consumers need to take greater charge of their medical consumption.
A week later, the orthopedist pulled up the scans and tapped a solid white bulge overlapping a long white strand. “You’ve heard of a ruptured disc?” he said. “That’s what this is.” The shooting pains up and down my right leg, the numbness in my right foot: one vertebra digging into the sciatic nerve.
Since I’m not being paid to guard Steph Curry, they did not recommend surgery, and I didn’t argue. So two days later, I limped to the sleek Yawkey Center at Mass General Hospital for an epidural. I was given a brief form to fill out while I waited. Was I diabetic? No. Was I taking any prescription blood thinners? No. Had I suffered any falls in the last three months? Well …
Being injected in the base of my spine was weird but, again, not terribly painful. The body is a tightly packed duffel; wedging a needle and a few CCs of cortisone into it feels uncomfortable. But afterward, the pain was gone. Nothing else had changed. I still limped, I still sat and rose stiffly. I did everything I’d been doing the last ten days; I just did it without pain. When you see pain as a necessary consequence of daring deeds like sitting on the edge of your bed or bending over to tie your shoes, it feels weird to enter a world without.
The pain came back, as the doctors promised me it would. The cortisone is meant to reduce the inflammation, give the afflicted nerve room to recover. Two days after the epidural, I started the PT regimen. It’s nothing terribly complex – flexing the legs, reverse crunches, partial situps. I just have to keep the core constantly engaged while I do it. The effort is more mental than physical—a meditative focus. While I worked the routine for the first time, the PT keeping a hand on my transverse abdominis to make sure they stayed taut, Michael Bolton’s “Back on My Feet” again played, because irony is a jealous god.
A friend asked how I’m feeling, and I said I was managing, which is what you do with pain. There are times I feel like sitting or lying down, and there are times I feel like standing up, and I can’t always predict what those times will be. On a crowded Red Line train to Harvard? Thirty minutes into a staff meeting? Four a.m.? My sciatic nerve is the clicking prong at the base of the Price is Right wheel, and I never know where it will rest.
The worst part of chronic pain is that it makes you self-centered. The pain calls attention to itself. Moment by moment it’s manageable, and there are long stretches where it goes away entirely, but when it resurfaces it catches you like a strobe light. You get so accustomed to pain that it poisons the rest of your thinking. You find yourself limping home like Ahab, snarling at passerby, irrationally angry at people who aren’t suffering like you are.
But of course they are. Everyone carries within them a bit of nagging pain, mental or physical. Everyone has their own 0 to 10 scale. And the only noble cause in life is looking up from one’s own pain long enough to ease someone else’s. Everything else is an evolutionary afterthought.