Aches and Pains
Dr. Lawrence Levin鈥檚 Poems and Essays from an Ordinary Room was published shortly after his death at age sixty-four. In it, he described surgery for a pinched nerve and ensuing hopelessness: years of 鈥渞age, rage, resentment, fear and sorrow.鈥 From far too much experience, Levin wrote, 鈥淲ith luck, acute pain is a positive adaptation for our benefit,鈥 danger signals eliciting care. Healing, hopefully, to follow. But, he noted, 鈥淣ot so with chronic pain.鈥
Doctors often use the visual analogue scale (VAS) to rate 鈥渟ubjective characteristics,鈥 that is, the immeasurable鈥攚hat the patient says he feels. Zero to ten, no pain to worst pain ever. As rheumatologist, Levin found patients resented having to respond to the VAS. And/or that as physician he saw no correlation between numbers chosen and visible signs of arthritis.
One day, himself now experiencing chronic pain, 鈥渇eeling alone, raw with misery and disappointment, and desperately helpless,鈥 Levin composed his own rating scale. By four, he鈥檚 at 鈥淚 don鈥檛 like this,鈥 by six, 鈥淭he intrusion is unrelenting,鈥 by nine, 鈥淒ear God. Deliver me from this suffering.鈥 And Dr. Levin鈥檚 ten? 鈥淚 am overcome.鈥
Virginia Woolf would have understood. In On Being Ill, she wrote, 鈥淏ut let a sufferer try to describe a pain his head聽 to a doctor and the language at once runs dry. . .He is forced to coin words himself, and, taking his pain in one hand, and a lump of pure sound in the other (as perhaps the people of Babel did in the beginning), so to crush them together that a brand new word in the end drops out.鈥
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鈥淚鈥檓 sick and tired,鈥 something else kids used to say. Sick and tired of homework/someone else complaining/having to walk to school in the snow and slush. But not actually sick, not actually tired.
Words that came to mind all these years later when an elderly friend said he was 鈥渢ired of life.鈥 He didn鈥檛 mean any problem in particular, just didn鈥檛 want yet another surgery, another hospitalization, no more chronic. . . not even pain, but discomfort.
鈥淓nough already!鈥 from the Yiddish genug shoyn. Think of Leonard Cohen鈥檚 鈥淚 ache in the places where I used to play.鈥 Wry, self-deprecating. (Cohen died at eighty-two.) Versus kvetching: “complaining, whining.鈥 Petulant grousing. . .
鈥淨uit it!鈥 we also said when I was young. And, 鈥淨uit your bellyaching!鈥
After my knee replacement surgery鈥攁mazing, almost superhuman, that a knee could be replaced!鈥攁 nurse told me, 鈥淵ou have to learn to live with your aches and pains.鈥 She meant well, but I heard the imperative.
The nurse鈥檚 admonition came when I asked for more painkillers. Timing is all: HMOs had discovered opioid abuse with as much authentic surprise as Hollywood discovered sexual harassment. To allay the nurse鈥檚 concerns, I explained, 鈥淔or more than a decade now I don鈥檛 drink liquor at all, never drank much anyway; haven鈥檛 smoked tobacco in more than four decades; no marijuana since early 1974, no cocaine since the early 1980s (and back then only if free).鈥
I might at a better moment, or as my better self, have remembered what great care the staff was providing. And that more medical resources were being spent on this one body than on the entire population of some countries. Also, I might have remembered the nurse had her own problems: tough commute, compassion fatigue, marching orders from above. Other patients too much like me. But when she repeated that I had to learn to live with my aches and pains, I started to reply, 鈥淎ctually, you should learn to live with my aches and pains.鈥 Luckily, the nurse was already speaking over what I was saying, telling me to ask the surgeon.
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I was left thinking about the words 鈥渁ches鈥 and 鈥減ains鈥. To begin with, the nouns are not married to each other. Should be divorced. Or separated forever, like Siamese twins at birth. As for the three-word phrase鈥aches and pains鈥攖wo nouns & conjunction, use of it should be prohibited by law. Further, each noun, even employed separately, should ever/only be invoked one ache or one pain at a time. If multiple aches or multiple pains are involved, each should be numbered, sums then totaled.
Doing this, you might get, in the course of one transit of the sun, thirty-two aches & twenty-seven pains. Not to mention that by being legally required to calibrate not just duration but factoring in the VAS number such as it is鈥攖hat is, the subjectively perceived intensity鈥攐ne might achieve some idea of what was never conveyed by the formerly legal aches and pains.
This for starters, though of course you have sensations not taken into acount by either word. Twinges, for instance (Old English twengan,聽鈥減inch, wring鈥), such a crunchy monosyllable catching a bit of the hurting. And then there鈥檚 grimace. Think grim, the grim reaper. (Grimace: the fear-aggression smile, tightening of lower face muscles women passing you on the sidewalk offer to simultaneously avoid/acknowledge/dismiss. Not that one blames them. . .)
Happy endings? Hydrocodone. My orthopedic surgeon assumed risk of addiction had to be weighed against misery of chronic pain. I was also blessed with a doctor friend who said he鈥檇 give assistance if needed. When I told him he was a lifesaver, he replied he couldn鈥檛 save anyone, but could try to help.
A thought. There鈥檚 that line of Nietzsche鈥檚: 鈥淲hatever doesn鈥檛 kill you makes you stronger.鈥 People in our positivity-plus nation of victimized complainers say this. May even believe it, unless they offer it wryly, ironically.
Thomas Farber has been awarded Guggenheim and, three times, National Endowment fellowships for fiction and creative nonfiction, and been selected a Fulbright Scholar, recipient of the Dorothea Lange-Paul Taylor Prize, and Rockefeller Foundation scholar at Bellagio. His recent books include Here and Gone, The End of My Wits, Brief Nudity, The Beholder, and Acting My Age (forthcoming). Former 糖心Vlog官方ing Distinguished Writer at the University of Hawai鈥榠, he teaches at the University of California, Berkeley. 鈥淎ches and Pains鈥 is from Acting My Age, the of M膩noa: A Pacific Journal of International Writing.