He treats patients with cancer, who often suffer extreme pain. My father raised me to believe that most pain is minor. He was never impressed by my bleeding cuts or even my weeping sores. In retrospect, neither am I.
Every time I go to the doctor and every time I visit the physical therapist, I am asked to rate my pain on a scale from zero to ten. This practice of quantifying pain was introduced by the hospice movement in the 1970s, with the goal of providing better care for patients who did not respond to curative treatment.
My father once told me that an itch is just very mild pain. Both sensations simply signal, he told me, irritated or damaged tissue.
But a nasty itch, I observed, can be much more excruciating than a paper cut, which is also mild pain. Digging at an itch until it bleeds and is transformed into pure pain can bring a kind of relief.
Where does pain worth measuring begin? With poison ivy? With a hang nail? With a stubbed toe? A sore throat? A needle prick? A razor cut?
When I complained of pain as a child, my father would ask, “What kind of pain?” Wearily, he would list for me some of the different kinds of pain, “Burning, stabbing, throbbing, prickling, dull, sharp, deep, shallow…”
Hospice nurses are trained to identify five types of pain: physical, emotional, spiritual, social, and financial.
The pain of feeling, the pain of caring, the pain of doubting, the pain of parting, the pain of paying.
Overlooking the pain of longing, the pain of desire, the pain of sore muscles, which I find pleasurable…
The pain of learning, and the pain of reading.
The pain of trying.
The pain of living.
A minor pain or a major pain?
There is a mathematical proof that zero equals one. Which, of course, it doesn’t.
The set of whole numbers is also known as “God’s numbers.”
The devil is in the fractions.
Although the distance between one and two is finite, it contains infinite fractions. This could also be said of the distance between my mind and my body. My one and my two. My whole and its parts.
The sensations of my own body may be the only subject on which I am qualified to claim expertise. Sad and terrible, then, how little I know. “How do you feel?” the doctor asks, and I cannot answer. Not accurately. “Does this hurt?” he asks. Again, I’m not sure. “Do you have more or less pain than the last time I saw you?” Hard to say. I begin to lie to protect my reputation. I try to act certain.
The physical therapist raises my arm above my head. “Any pain with this?” she asks. Does she mean any pain in addition to the pain I already feel, or does she mean any pain at all? She is annoyed by my question. “Does this cause you pain?” she asks curtly. No. She bends my neck forward. “Any pain with this?” No. “Any pain with this?” No. It feels like a lie every time.
On occasion, an extraordinary pain swells like a wave under the hands of the doctor, or the chiropractor, or the massage therapist, and floods my body. Sometimes I hear my throat make a sound. Sometimes I see spots. I consider this the pain of treatment, and I have come to find it deeply pleasurable. I long for it.
The International Association for the Study of Pain is very clear on this point — pain must be unpleasant. “Experiences which resemble pain but are not unpleasant,” reads their definition of pain, “should not be called pain.”
In the second circle of Dante’s Inferno , the adulterous lovers cling to each other, whirling eternally, caught in an endless wind. My next-door neighbor, who loves Chagall, does not think this sounds like Hell. I think it depends on the wind.
Wind, like pain, is difficult to capture. The poor windsock is always striving, and always falling