Real pain

MAKING IT PERSONAL: Though the medical profession tries to clarify, classify and quantify, it's the most intimate of companions.

Published September 27, 2005

Chronic pain: The very words will make anyone wince who has lived with an illness, injury or disease that rides like a dark cloud over life.

Debilitating pain: Pain that buckles the knees, impairs vision, and emerges in screams and moans. Pain that saps joy from normal life.

What is your pain on a scale of 1 to 10, 10 being the most intense?

This question appears on medical forms in doctors' and physical therapists' offices. The answer will depend on the patient's experience. For example, a 2 for a person living with chronic pain might send a healthier person to the emergency room.

On the forms, the patient is asked to mark where the pain is. Front or back? Right or left? The patient must sort through a whole vocabulary of pain: pins and needles, stabbing, burning, tingling, aching, throbbing.

What it feels like might be more like the following:

  • a thrust from a red-hot poker;

  • stabbing and twisting of a knife;

  • a Taser dart, imbedded;

  • a never-ending charley horse;

  • a tourniquet that stays on;

  • being a human pincushion;

  • being attacked by bees;

  • being slammed in a car door;

  • having a stake or nail driven in;

  • being beaten by a hammer;

  • something like a grenade exploding inside.

    In the 1936 movie Modern Times, Charlie Chaplin, a hapless factory worker, is drawn into the gears of a large machine. Being racked by pain is like having the flesh pressed and torn by the teeth of those gears.

    Medical practitioners offer a selection of pain control: physical therapy, surgery, chiropractic manipulation, heat and ice, ointments and patches, meditation, yoga, massage, acupuncture, herbs, injections, rest, exercise and drugs - lots of drugs. Enough that you can sleep or sleepwalk through life.

    Patients facing surgery or dealing with illness are urged to keep a positive perspective. Laughter and humor are touted as tools for recovery. Mental attitude and the ability to relax are things patients can control. They can affect medical outcomes, research has shown. Survival might hang on the edge of one's outlook.

    But the presence of pain in so many lives cannot be denied. Some patients hurt horribly, and all the morphine drips in the world will not change that.

    Why is there so much pain?

    Because many people can't afford treatment, because patients don't tell their doctors, because doctors don't listen, because patients and doctors fear addiction and side effects, which can be worse than the pain, and because some pain is untreatable.

    Suffering seems to be the human lot, especially as the body ages and the degenerative process takes hold. Fortunate are those who can live life fully and comfortably to old age. Others will encounter excruciating pain that disables and depresses them, chronic pain that makes them cranky and annoying to others. A sign in an Atlanta surgeon's office sums up the human experience of suffering: Pleasure is the absence of pain.

    -- Martha Jacobs can be reached at jacobs@sptimes.com