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Screaming in Pain—and Laughing in Wonder
Sciatica, synthetic opioids, mind over matter, Maia Szalavitz, Holly Whitaker, Joan Didion, pain yoga, and Dakini Bliss.
My back has been killing me. I know, we’ve all heard that a million times. Back pain must be one of the oldest and also one of the most common complaints of the modern world—and one which, at this point, most of us are familiar with, sitting as we do at desks for so much of the time. And, although I hope that you don’t, you may well know what I mean when I say that I’ve experienced enough level-ten agony emanating from my lower back to know just how totally hopeless it can make me feel, and so very quickly. Serious pain that appears from seemingly nowhere, and calls incessantly for your full, unblinking attention is not just debilitating, from the pain and fatigue, the lack of proper sleep, and from the psychological effort required to manage the sensations, but it drives a wedge into life as if to say: this could all change, right here, right now.
The pain marks a point from which, it can so suddenly seem, there may be no return. Past loves and pursuits quickly recede as the present reality clamors for attention, which, along with the pain, includes the fear that the pain won’t ever go away—the fear of getting caught in its clench, right here in bed, and of not being able to return to being who I was even three weeks ago. It grips like a charley-horse, and all I can think of is escape—and it grips me with the fear of the potential of a cruel termination of my career as a middle-aged trail runner, and that with the increasingly-rare greening of the golden hills of California that comes with what little winter rains we may be blessed with quickly approaching. The best time of the year for running—and I can barely walk.
And yet, right now, even with this hellacious burning in my upper-left outer thigh and the pain in my actual, literal ass that has me wide awake and screaming at four a.m., and even with the fear that I may undergo some sort of involuntary transformation that will involve a dusty-blue disabled parking placard instead of the luminous spiritual awakening that I was hoping for—even with that, right now, at the same time, I’ve never felt happier, more grateful for, and more in love with the small things in life.
So, I have been screaming, yes—and also laughing, because what else am I going to do in the pre-dawn darkness when I’m awakened by a shooting, searing, pulsating nerve pain that originates from the left side of somewhere around L3-L4, finds its way down through my hip and then comes around and up the side of my thigh like the whip of a man-o-war—but worse, because it’s deep inside. It feels like my femur is on fire. It feels like someone stripped the ends of an extension cord, wired the positive and negative ends to my IT band and switched on the current. The deep muscles in my thigh are in spasm, convulsing in an unbearable paroxysm that seems like it will never end. Just a few weeks ago, I was happily hiking and running fifteen miles at a time, and now, I feel condemned to a sleepless hell, up in the middle of the night trying to jam my elbow far enough into my quadricep to root out the source of the pain, medicated, groggy, and knowing that the coming day will only bring more of the same, along with a total inability to concentrate on anything productive, including the writing that I want and, really, need to do to be myself these days.
At this point I’m familiar with just about all of the ways in which what Steven Pressfield calls Resistance can show up, but this is a new one—and so, after a break here to search up and order a standing desk—and to take a nap to make up for the lack of normal sleep, I’m back in front of the keyboard. Take that, you bastard imp—I’m still here!
In terms of pain, I’m sure many of you know exactly what I’m talking about. Lying down fails to provide relief, and can even make it worse from the pressure. The best things for it don’t involve sitting or lying down all—walking, the figure-four stretch, holding plank pose, and what PT’s call, in way that I find very unappetizing, “nerve flossing.” Yeah, doesn’t sound so great right? This last movement is an effort to pull the huge nerve that runs down the middle of your leg from your spine to your knee or wherever back and forth in its socket enough to—I don’t know, unstick it? Lubricate it? Remarkably, it often does help, if only for about three seconds at a time.
The drugs, of course, don’t really help much at all. I mean, back in my thirties, after I first herniated a disc racing a German guy named Hans on a sailboard down in Venezuela, I used to love the Tramadol that they kept handing out to me. Even after a surgical microdiscectomy (just a little snip, arthroscopic, quick job), which did in fact relieve the pain at its source, I had some scar tissue and a weak spot that remained prone to throwing off burning sensations, and so I’d never leave the house without one of those little pills in the coin pocket of my jeans. As familiar as I was with the onset of the lopsided growl of discomfort that would so often issue from my lower-left side, I’d find myself sticking the tip of my index finger in that special pocket repeatedly through the course of an evening to assure myself that I had some backup from big Pharma—and, since I was carrying, I’d usually end up using.
The right time to pop that little 50mg tab most often came after I’d been at the bar for long enough to have had a couple of drinks—and if I’d been standing there, as I usually was, leaning against the bar, swiveling my head back and forth, scanning for someone I might know or anyone else that seemed willing to engage, that was also about the time that I’d start to feel the tables turning towards a less-than-fun feeling in my lower back. The end result was my own particular cocktail of synthetic opioid washed down with Makers and soda—something that I thought of as my very own “Bourbon Dwelle,” but that must be familiar to many Americans (and others), given the 17-plus million prescriptions for Tramadol that are written each year in this country alone.
At the time I thought that I enjoyed the gluey, grey feeling of internal compression brought on by the combination of pain killers and alcohol. I was used to it, and so I didn’t notice what I imagine others did—the subtle slur and sleepy-eyed slant of my sayings at the time.
As I found out when I went to see my Kaiser doc the other day, they’re still prescribing exactly the same shit when you show up presenting with severe sciatic pain. Not exactly high tech when you think about it, dosing your whole body with a powerful chemical that come with several nasty side effects—in my experience, itchiness, nausea, instability, fuzzy head, “decreased alertness,“ and a general sense of what feels like gross chemicals in my body—not to mention the fact that the meds neither alleviate the pain entirely, nor do they, needless to say, do anything to address the root cause of the symptoms. When you add all of that up with the fact that I no longer enjoy being drunk or high on factory dope, at this point, the pills do more harm than good—which doesn’t stop me from thinking as I write this that tonight I’ll pop one of those little babies as I go to bed, in the hope that I’ll be able to get at least a few hours of uninterrupted sleep before the fire starts again.
Aside from exercises and walking (five miles today!), it might be interesting to hear that I’ve had some success using my mind to work with the agony when it’s at its most relentless. There’s a cycle of getting worked up in the worst of it, with the inside of my leg throbbing in continuous, reverberating, electric shock that is only made worse by the induced muscle tension and the continual stab of awareness around the source of the pain, wherever it seems to be located. Sometimes—I’m doing it right now actually—I can focus on the origin and consciously relax that internal area, releasing some of what feels like the grip of tissue surrounding the pulsating nerve—and, incredibly, that can make a difference. At least so far though, it only helps from moment to moment, and doesn’t prevent the whole thing from coming back again and again, or from keeping me up at all sorts of odd hours.
This is just something that I came upon myself, although I’m sure that if you get into the world of what’s called pain management—they try to make it sound benign—there are all sorts of techniques for trying to attenuate pain with the power of consciousness. Joan Didion writes in her 1968 essay In Bed about having “reached a certain understanding” with her frequent migrane headaches, and how this “imposed yoga, the concentration on the pain,” was followed, when the pain receded, by “a pleasant convalescent euphoria.” Her euphoria notwithstanding, I do dearly hope that I don’t have to get any better at this particular variety of mind over matter. I’d much prefer—and here, ”prefer” is one hundred percent a synonym for pray—for it just to go away.
I’ve been through this before, and I am optimistic. I have a strong constitution, and I’m confident that soon enough this will just vanish or at least subside below the level of awareness, in part because it has come and gone in the past—and also because, man, if it doesn’t, I’ll just cut the leg off and chuck it straight into the waters of Richardson Bay with all the other flotsam. I know, it’s probably not really that practical of a solution, but right now it feels like it could be preferable to saw it off at the hip myself and dump it overboard, after which I could sit back and relax to watch as it floats slowly away, twitching and sizzling, the water boiling around the severed limb from the heat of inflamed nerves still firing, a cluster of confused fish waiting for their chance at a bite of neurologically barbecued human road-kill.
This dramatic bit of recent physical suffering serves to remind me of other times when I’ve felt to be suffering from a range of other common-enough small-t traumas—depression, anxiety, loneliness, alcohol addiction, hangover, sexual frustration, and a nearly-terminal lack of purpose, just to name a few. As with those times in the past, it’s not just the pain in the moment—it’s the feeling that is how I am now, and that how I am now will likely remain how I am forever.
This time around though, something feels different. For one, I don’t feel so hopeless. I have a fair degree of confidence that the pain will recede, that I won’t be stuck in bed crying, and that I’ll get back to running—and, or—that if absolutely necessary, I’ll find something else to do with my body that feels good in the outdoors. In short, I’m not feeling so stuck—even though I did cry the other day as I was awakened from a fitful sleep, yet again, by the not-so-subtle tingle of what felt very much like a cattle-prod (and I know what one feels like, but that’s another story). Something is granting me the ability to see that I won’t be jabbed by this tormentor forever—and, even more importantly—that even if I do have to change how I live somehow as a result of this latest lesson in my own neurophysiology, that that won’t necessarily be the end of the world.
This counter-traumatic glow of optimistic positivity didn’t just come upon me this last two weeks along with the sciatica—let’s not give the pain any credit, lest we jinx it into sticking around!—but it is particularly striking, given how I find myself currently stricken.
The question is, what’s changed that has me feeling so groovy, even with the grinch grabbing at the nerve running through my gluteus?
What comes to mind is that over the past couple of years really, and now more and more often, is that instead of trying to conjure some sort of mystical gratitude that we’ve all heard that we should be doing our best to cultivate, these days, I often feel a powerful sense of goodness, ease and satisfaction just welling up of its own accord.
Again, I probably shouldn’t say too much— I don’t want to spook this pleasant feeling into disappearing, but I think it does bear describing, because although maybe this is just a regular everyday happy Monday morning for you, but for me, and I think for a lot of people, no, not at all. I just finished Maia Szalavitz’s 2016 book Unbroken Brain, and something she wrote really rings a bell for me—“The fact that depression is joyless isn’t itself especially shocking, of course. …what I did find remarkable was that I hadn’t even noticed the loss of so many different types of pleasure and reassurance. I recognized their reappearance with great relief and with wonder…[emphasis added].”
Fair enough, life is pretty good these days, but that’s not so much the point, as anyone who has ever experienced depression will tell you—it’s that coming out from such a joyless place, within which I was aware that I was missing a lot, but also very much unaware of the full extent of what I was missing—into a place of life where I can feel what feels like goodness all around me…that is quite a change, and the sheer wonder that she describes—in her case coming out of not only depression but also a heavy-duty addiction to injected cocaine and heroin—that wonder feels like what I am feeling.
If your emotional baseline is below neutral, everything has at least a touch of grey—and, for many, myself included, it wasn’t just grey, it was pretty much black. This ”wonder” that Szalavitz refers to isn’t a big wow because the world changes all of a sudden to become so fucking amazing. The world—the natural world, first of all, but also much of what we humans have created in what ends up as the normal, everyday world—has been wonderful all along. The wonder comes from removing the filter of depression, intoxication, and semi-permanent hangover—or sciatica, or migraine—that was obscuring the beauty of being alive on a day to day basis. It’s not that the wonder wasn’t there—it just wasn’t getting through to me.
In more recent years, my emotional baseline has risen above the low-water mark—and it has continued to rise, to a point where my emotional valence is now generally…somewhat positive. I say that with ellipsis in part because of my allegiance to a deeply-ingrained suspicion of everything that doesn’t reverberate with negativity and nihilism, and it does still feel a bit foreign, but I’m feeling this appreciation of the beauty of the ordinary often enough these days that I think, just possibly, that it may finally be sinking in.
It’s becoming part of how I am, and just as it can suddenly seem that everyone is driving the model of car that you started thinking about buying, I’m starting to recognize this quality of wonder and positivity in other people more and more. Don’t get me wrong, I still don’t hang well with people who are over-enthusiastically, overtly positive—you know the type, those people who seem to be trying to convert you, right?—but I also don’t snicker and shade the warm glow that comes from subtle, authentic positivity.
And here’s the thing—I can still feel this goddamn golden glow right now, even with the jabbing in my leg. I don’t know if I can quite grasp the pain in my ass as a “rare and special opportunity” asput it, and of course I would love for it to disappear, but in the meantime, the wish for it to go away isn’t getting in the way of my what is, very simply, my joy.
What Didion described, and what I think I’m feeling some of too, is what Pema Chödrön learned to call Dakini Bliss—taking an interest in the pain and the resulting fear, instead of just resisting it. I know, it sounds too good to be true, and it’s not like I heard about this concept and tried it (although that might well work)—it’s more that this is just where I’ve found myself along the way here. That said, I can report that seeing the pain that I’m experiencing as part of my overall experience of being, at the moment, and being able to feel that overall feeling of being as something like okay sure does make the pain a lot easier to live with, as does the gratitude, and euphoria, and wonder that I feel as the beauty of the world is revealed to me further every day.
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You might enjoy some of my other writing on the subjects of depression, spirituality, writing, and addiction, especially The Periodic Table of Love, with Michael “Roddy” McDowell. I mentioned a couple of writers above, Maia Szalavitz’s 2016 book Unbroken Brain, Holly Whitaker—her book is Quit Like a Woman and podcast called Quitted, as well as Pema Chödrön’s Taking the Leap.
Please stick around — I’ve got some questions for you…
How have you dealt with acute and/or chronic physical pain?
Have you ever been able to form a relationship with suffering in a way that leads to a special sort of bliss?
What is your own relationship with addiction, and/or with freeing yourself from old habits and fears?