Wednesday, June 29, 2011

An Education In Pain Pt. 2

Heavy eyelids open to an unfamiliar place. Realization follows immediately. I am still alive. The inevitable trailing thought, but for what, is saved for another time. My surroundings reveal my situation. A small room with a single bed in the center. The screen to the right displaying what could only be a set of vital signs. IV bags dangle like fruit from a steel tree, slender lines carrying their juice down out of my sight. The collar wrapped tightly around my neck restricts my movement, denying me a chance to see more. My limbs remain unresponsive. The sedation continues its steady retreat.

Outside my door doctors and residents discuss the case. Male, age 25. Brought in after a diving accident. X-rays revealed heavily damaged C4 and C5 vertebrae. Incisions were made in both the front and back of the neck in order to remove all of the bone fragments. C3 and C7 vertebrae were then fused in front and rear using donor bone, metal plates, and screws. Surgery completed in eight hours. Patient is stable with breathing and feeding tubes in place. Antibiotics and pain medication are being delivered through IV. Pain medication must be administered with a careful balance in mind. Use too much and the vital signs will slow to dangerous levels. Use too little... well, more pain is the safe option. A relatively new pain med is being tried, but it will take a few days to kick in.

The first night was the worst. Or was it the second? Impossible to say. The pain in my neck is a crackling fire. Continually burning away, but never deep enough to kill the nerves as a real fire would. Moving hurts. Staying still hurts only slightly less. I think back to my previous experiences dealing with pain. Over the years I have worked with Zen methods of dealing with pain. They are a kind of meditative technique that allows you to drop under the pain. Like diving under the surface as oil burns above you. With enough practice and meditation you can go deeper for longer. It has allowed me to sit in freezing water, walk barefoot on frozen ground, and drive calmly to the ER as my appendix swelled close to bursting. This pain is like nothing I had ever felt before.

As the hurricane sweeps over me I search for the eye. I reach for my place of peace. It starts with controlled breathing. The tube pressed into my lungs denies me that control. Thick goo fills my nasal cavity, choking me as I try to breath. The fire burns hotter, mocking my attempts to dive under it. The bed begins to move. First it starts to vibrate, then it starts to tilt. A voice at the back of my mind tells me that this is supposed to help with bed sores, but all I can feel is the vibrations stoking the fire in my neck. The vibrations become more violent, the bed pitches me from side to side. Is this part of the medical process? Is this supposed to help me heal? A nurse is always on duty. Sitting just behind the glass, glancing up occasionally. How am I supposed to say anything with the tube in my throat. I guess no one can hear you scream. The vibrations are out of control. The bed stands me on end. Is this a new torture technique? Am I the test subject? My thoughts begin to stretch and twist. They break apart, the words blowing away in the wind. I reach for the center, and am swept away by the storm.

Sometime later I came out the other side. Words forming back into sentences. Thoughts forming back into me. It took me some time to figure out where I had been. Or rather, where I hadn't been. If someone ever tells me that their pain feels like a 10 out of 10 I will smile sympathetically, but inside I will shake my head. If you are there, you simply would not be able to tell anyone. It is a place where your personality breaks apart, and all that is left is pain. In that place there is no I. No one to feel the pain. No one to tell about it. Perhaps that is a good thing.

There are many more stories from the ICU that I could tell. There is the one about the respiratory therapists removing the breathing tube and sucking the goo out of my nose. I could talk about the hallucinations I saw over those four days. Hallucinations that make a vibrating, tilting, bed seem oh so normal. I could talk about how I got out of the ICU in four days when they said it would be 7 to 10. I could even go on about the rest of my fight with the pain, but I think it can all be summed up by one memory that stands out clearly in my mind. Sometime after the breathing tube had been removed, a nurse leaned over and asked if there was anything I needed. All I could say, was "hope..."


  1. This is so beautifully written, Craig. Thank you for this.

  2. Amazingly written, Craig.
    Keep writing. Keep writing. Please, keep writing.
    And being you.

  3. You touch a place in my heart like no other. How could any of us ever know the pain you experience and thoughts you've had if you didn't share as you are. You have put "real" pain into perspective for me. This is a brave thing you are doing. Thank you, Craig! Hope is alive and God will provide. My prayers and love, Aunt Vicki

  4. Hey it's Erin (King) -

    Thank you so much for posting this. We learn so much in school about patients in the ICU and how to prevent and treat delirium and agitation. What medications to give and which to avoid. I've actually read a blurb written by someone who was never in the ICU that was supposed to be about what it would be like to wake up there.

    It is so helpful to have this window to glimpse in and see what it's like on the patient side. It's so much more real and intense than we, as the healthcare team, ever stop to think about. Often, the ICU rounding team thinks of "life" as a summation of vital signs and prognosis. But it's so much more, and this little window has think of my future patients a little differently.

    Thank you for sharing your journey with us. Continuing to pray for you -

  5. Craig, How incredibly clear it becomes that we can never ever begin to be where you are, to feel where you are. Your writing helps me know how little I know about what you are living through.

    *My* hope, prayer, wish for you is that you'll find the hope you need each and every day. Emily Dickinson wrote "Hope is the thing with feathers." So perhaps all those cranes in your room are one vehicle of hope.

    With this blog, you are not just sharing your experience with us -- in itself, a humbling gift. You are also inviting us to reflect upon our broader human experience, and that insight, that impetus, and that clarity is what makes your writing so great.

    Wishing you love and light, your cousin Diane

  6. This is a test comment! I love you!

  7. Craig we think of you often and pray for you daily. We too hope and pray that you find the hope and inspiration you need each day. We appreciate you letting us have a glimpse into what you're experiencing. Please, keep writing.

    Love you, your cousin Michelle and family.