The concept of pain seems so simple. Something either hurts us, or it doesn't. Looking closer, there is so much more. Pain is both necessary and unwanted. In reality pain is information, knowledge for a price. Pain tells us about our boundaries. We experience pain when we push into the boundaries, on purpose, accidentally, or forced by an external source. When we run, our muscles and lungs tell us when we approach the limit of our strength and conditioning. In the case of athletics, we seek to push that boundary ever outward. When we are hot or cold, our bodies tell us that we are approaching the limit of our temperature tolerances. When we are injured, our bodies use pain to inform us that the damaged area requires urgent attention. Where would we be without these kinds of pain? There are, in fact, people who have full control of their bodies while having no sensation. In effect, they can do everything a normal able-bodied person can do. They just don't have a sense of touch. As it turns out, these people are very injury prone. What if you set your hand down on top of a hot stove and did not notice? What if you stubbed your toe and broke a bone? What if you stepped on a nail? Pain allows us to reflexively remove our hands from hot surfaces long before the smell of burning flesh could warn us. Pain tells us that our toe hurts long after it should have stopped hurting, and maybe we should see a doctor. Pain tells us that we punctured our foot and need to take care of it before we get an infection. Pain is knowledge for a price.
Not all pain is physical. Perhaps even a majority of the pain we feel in our lives is emotional. Where does it come from? What does it tell us? A complete exploration of these questions could fill volumes. To keep this from going on forever, I will try to be brief and only say a few things about emotional pain as it relates to my situation. We have an image of ourselves. A person that we believe ourselves to be. We also have an image of the world around us. A belief in how things are supposed to work. These two things are interrelated. When one of them is challenged or changed, the other often is as well. It can be very distressing to face change. To find out that things are not as you thought, or that they can no longer be as they were. In this case, pain is a matter of resistance. Do we bury these challenges inside us, letting them fester? Do we deny a truth because it is different? Do we face our reality no matter how terrible or unthinkable, and acknowledge this is real, this is now, what next? Our pain, in this case, is a measure of how hard we cling to the past.
It can also be said that physical pain and mental state change each other in positive or negative ways. Our past experiences can help us deal with physical pain, or leave us extremely distressed with minimal provocation. A standard practice in hospitals is to ask patients to rate their pain from 1 to 10. The pain scale on my wall lists 0 as no pain, 2.5 as mild, 5 as moderate, 7.5 as severe, and 10 as the worst pain possible. Some hospitals say that 10 is the worst pain you can imagine. This is true at the hospital where a friend of mine works in the ER. A sample of the stories from the ER include a man with a stubbed toe who claimed to normally have a high tolerance to pain, but his toe definitely rated a 9 on the scale. A woman also claimed to normally have a high tolerance to pain, apparently this is a pretty common preface, but the cut on her hand rated an 11 on the scale. Either these people have no experience, or no imagination.
At times I have wondered if the scale is linear. Is a four twice as painful as a two? Is an eight twice as painful as a four? The answer is no, not by a long shot. What is the worst pain possible? What does it mean to have a 10 on the pain scale? It was beyond my imagination. Perhaps if I relate my experience to you, it will no longer be beyond yours.
My memories of the ICU are spotty at best. I cannot say in what order some things happened. Perhaps the only marker of time that I have is the breathing tube. Half drowned in lake water, with weakened lungs, and requiring extensive surgery, I had a tube inserted into my airway. As the name implies, the tube helped me breath. It also prevented me from speaking. As I woke up, I remembered the accident, and still could not move my limbs. My paralysis was readily apparent, but so was the physical pain. I could not deal with both at the same time, and the physical pain was not going away. This began my education in pain.
to be continued in part 2...