Touchstone Anthology of Contemporary Creative Nonfiction (10 page)

There is no evidence of pain on my body. No marks. No swelling. No terrible tumor. The X-rays revealed nothing. Two MRIs of my brain and spine revealed nothing. Nothing was infected and festering, as I had suspected and feared. There was no ghastly huge white cloud on the film. There was nothing to illustrate my pain except a number, which I was told to choose from between zero and ten. My proof.

“The problem with scales from zero to ten,” my father tells me, “is the tyranny of the mean.”

Overwhelmingly, patients tend to rate their pain as a five, unless they are in excruciating pain. At best, this renders the scale far less sensitive to gradations in pain. At worst, it renders the scale useless.

I understand the desire to be average only when I am in pain. To be normal is to be okay in a fundamental way — to be chosen numerically by God.

When I could no longer sleep at night because of my pain, my father reminded me that a great many people suffer from both insomnia and pain. “In fact,” he told me, “neck and back pain is so common that it is a cliché — a pain in the neck!”

The fact that 50 million Americans suffer from chronic pain does not comfort me. Rather, it confounds me. “This is not normal,” I keep thinking. A thought invariably followed by a doubt, “Is this normal?”

The distinction between test results that are normal or abnormal is often determined by how far the results deviate from the mean. My X-rays did not reveal a cause for my pain, but they did reveal an abnormality. “See this,” the doctor pointed to the string of vertebrae hanging down from the base of my skull like a loose line finding plumb. “Your spine,” he told me, “is abnormally straight.”

I live in Middle America. I am of average height, although I have always thought of myself as short. I am of average weight, although I tend to believe I am oddly shaped. Although I try to hide it, I have long straight blond hair, like most of the women in this town.

Despite my efforts to ignore it and to despise it, I am still susceptible to the mean — a magnet that pulls even flesh and bone. For some time I entertained the idea that my spine might have been straightened by my long-held misconception that normal spines were perfectly straight. Unknowingly, I may have been striving for a straight spine, and perhaps I had managed to disfigure my body by sitting too straight for too many years. “Unlikely,” the doctor told me.

A force 6 wind on the Beaufort scale, a “Strong Breeze,” is characterized by “large branches in motion; telegraph wires whistle; umbrellas used with difficulty.”

Over a century before preliminary scales were developed to quantify the wind, serious efforts were made to produce an accurate map of Hell. Infernal cartography was considered an important undertaking for the architects and mathematicians of the Renaissance, who based their calculations on the distances and proportions described by Dante. The exact depth and circumference of Hell inspired intense debates, despite the fact that all calculations, no matter how sophisticated, were based on a work of fiction.

Galileo Galilei delivered extensive lectures on the mapping of Hell. He applied recent advances in geometry to determine the exact location of the entrance to the underworld and then figured the dimensions that would be necessary to maintain the structural integrity of Hell’s interior.

It was the age of the golden rectangle — the divine proportion. Mathematics revealed God’s plan. But the very use of numbers required a religious faith, because one could drop off the edge of the earth at any point. The boundaries of the maps at that time faded into oceans full of monsters.

Imagination is treacherous. It erases distant continents, it builds a Hell so real that the ceiling is vulnerable to collapse. To be safe, I think I should only map my pain in proportion to pain I have already felt.

But my nerves have short memories. My mind remembers crashing my bicycle as a teenager, but my body does not. I cannot seem to conjure the sensation of lost skin Without actually losing skin. My nerves cannot, or will not, imagine past pain — this, I think, is for the best. Nerves simply register, they do not invent.

After a year of pain, I realized that I could no longer remember what it felt like not to be in pain. I was left anchorless. I tended to think of the time before the pain as easier and brighter, but I began to suspect myself of fantasy and nostalgia.

Although I cannot ask my body to remember feeling pain it does not feel, and I cannot ask it to remember not feeling pain it does feel, I have found that I can ask my body to imagine the pain it feels as something else. For example, with some effort I can imagine the sensation of pain as heat.

Perhaps, with a stronger mind, I could imagine the heat as warmth, and then the warmth as nothing at all.

I accidentally left a burner on the stove going for two and a half days — a small blue flame, burning, burning, burning…

The duration terrified me. How incredibly dangerous, so many hours of fire.

I would happily cut off a finger at this point if I could trade the pain of that cut for the endless pain I have now.

When I cry from it, I cry over the idea of it lasting forever, not over the pain itself. The psychologist, in her rational way, suggests that I do not let myself imagine it lasting forever. “Choose an amount of time that you know you can endure,” she suggests, “and then challenge yourself only to make it through that time.” I make it through the night, and then sob through half the morning.

The pain scale measures only the intensity of pain, not the duration. This may be its greatest flaw. A measure of pain, I believe, requires at least two dimensions. The suffering of Hell is terrifying not because of any specific torture, but because it is eternal.

The square root of seven results in a decimal that repeats randomly into infinity. The exact figure cannot be known, only a close approximation. Rounding a number to the nearest significant figure is a tool designed for the purpose of making measurements. The practicality of rounding is something my mind can fully embrace. No measurement is ever exact, of course.

Seven is the largest prime number between zero and ten. Out of all the numbers, the very largest primes are unknown. Still, every year, the largest known prime is larger. Euclid proved the number of primes to be infinite, but the infinity of primes is slightly smaller than the infinity of the rest of the numbers. It is here, exactly at this point, that my ability to comprehend begins to fail.

Although all the numbers follow each other in a predictable line, many unknown quantities exist.

I do not know how long I have been clenching my teeth when I notice that I am clenching my teeth. My mind, apparently, has not been with my body. I wonder why, when I most want to, I cannot seem to keep my mind from my body.

I no longer know who I am, or if I am in charge of myself.

Experts do not know why some pain resolves and other pain becomes chronic. One theory is that the body begins to react to its own reaction, trapping itself in a cycle of its own pain response. This can go on indefinitely, twisting like the figure eight of infinity.

My father tells me that when he broke his collarbone it didn’t hurt. I would like to believe this, but I am suspicious of my father’s assessment of his own pain.

The problem of pain is that I cannot feel my father’s, and he cannot feel mine. This, I suppose, is also the essential mercy of pain.

Several recent studies have suggested that women feel pain differently than men. Further studies have suggested that pain medications act differently on women than they do on men. I am suspicious of these studies, so favored by
Newsweek
, and so heaped upon waiting-room tables. I dislike the idea that our flesh is so essentially unique that it does not even register pain as a man’s flesh does — a fact that renders our bodies, again, objects of supreme mystery.

But I am comforted, oddly, by the possibility that you cannot compare my pain to yours. And, for that reason, cannot prove it insignificant.

The medical definition of pain specifies the “presence or potential of tissue damage.” Pain that does not signal tissue damage is not, technically, pain.

“This is a pathology,” the doctor assured me when he informed me that there was no definitive cause of my pain, no effective treatment for it, and very probably no end to it. “This is not in your head.”

It would not have occured to me to think that I was imagining the pain. But the longer the pain persisted, and the harder it became for me to imagine what it was like not to be in pain, the more seriously I considered the disturbing possibility that I was not, in fact, in pain.

Another theory of chronic pain is that it is a faulty message sent by malfunctioning nerves. “For example,” the Mayo Clinic suggests, “your pain could be similar to the phantom pain some amputees feel in their amputated limbs.”

I walked out of a lecture on chronic pain after too many repetitions of the phrase, “We have reason to believe that you are in pain, even if there is no physical evidence of your pain.” I had not realized that the fact that I believed myself to be in pain was not reason enough.

We have reason to believe in infinity, but everything we know ends.