Something Good #95: It Hurts When I Do This
Patient says, “Doctor, it hurts when I do this.”
Doctor says, “Then don’t do that.”
— Henny Youngman
The problem started in September, when I woke up with a mild but persistent ache in my left forearm. Later in the day, working at my desk, it felt like somebody was pouring hot lava onto my shoulder. I shrugged it off—working hunched over a computer for decades accustoms you to all sorts of transient physical agonies—but over the following days it got worse and worse. At its nadir, a few weeks later on a trip to a film festival in Germany, it felt like my left arm was being pulled towards the ground by an invisible weight, the now-useless limb flickering with sharp red sparks of pain. Stumbling through the tidy town square, I realized I had never hurt like this before.
I felt like a broken marionette. It affected my entire range of motion: looking down was painful, looking up was worse. For months I slept with my neck propped up at just the right angle to give me enough relief to black out. My physiotherapist cringed in sympathy, telling me the pain was neuropathic, caused by a pinched nerve in my neck. It was what she referred to as “referred pain,” meaning, there was nothing wrong with my arm at all, but that the pressure of the compressed tissue on the nerve was causing my brain to receive a faulty signal indicating something terrible was happening somewhere in the vicinity of my elbow, and reacting with according alarm.
Slowly, things improved. In December, just as I was almost entirely recovered from the situation with my arm, I got a terrible cold, not COVID, but one that involved a stuffed-up ear, post-nasal drip and a lot of coughing. At one point I coughed so violently that I the world darkened around me and I felt myself about to lose consciousness, and, honestly, I welcomed it. But the net result of all that violent hacking was that I pinched a new nerve, this one in my lower back, which caused an almost exact echo of the neck/arm symptoms, but this time in my knee, lower leg, and foot, which as of this writing continue to distress me in new and interesting ways.
Physical pain has qualities of its own, it has quirks and contours and depth. It is an entire world of sensation to taxonomize. But as soon as we stop feeling it, we leave it behind and forget it. It’s not fun to think about and we’d just as sooner go back to the world without it—because the world itself really does change when you’re suffering. Maybe that’s why it’s so absent, as a topic, from our culture. And for that reason, none of us come to the experience really prepared for it. We enter the country of pain alone, and when we come back we never bring a map.
The point of telling you this is not to solicit sympathy or worse, pity. My season of pain has sucked, but I’m fine and my condition continues to improve. You’re not reading a scary medical mystery. This is all as mundane as it gets. But… I have had a front-row seat to pain for the last several months, long enough that it has been impossible to do what I usually do and ignore it. It’s caused me to think a lot about what it feels like to hurt, and why it’s so hard to talk about.
The topic has certainly been examined; there’s a whole field of science dedicated to pain, and it’s an urgent issue on a social, economic and medical level. The opioid epidemic has drawn attention to how many people live with chronic pain, and how few effective treatments there are for it. (I highly recommend Brian Goldstone’s heartbreaking Harper’s article “The Pain Refugees,” on the topic of chronic pain-sufferers who can no longer access the only medications that allow them to live a bearable life, denied them for reasons that are more based in moralizing than evidence.) Gender bias in treatment is still widespread, with a long history of doctors dismissing women’s pain, to the point where studies can indicate to the minute how much faster men are given painkillers in emergency rooms. The repercussions of this feeling (probably the most universal feeling there is) are everywhere, and I have no doubt there are many communities where it is discussed and examined.
But it’s underrepresented in popular culture, if not totally ignored. Action movies are full of stunts that would permanently disable the characters who perform them, let alone hurt like hell. How often have you jumped off a rooftop and fallen through a skylight, only to brush yourself and keep running? But we can easily suspend our disbelief, because the movies rarely stop to let us feel the impact of what we’re watching. (Some movies do; the golden age of Hong Kong action cinema, with its real stunts and frequent on-set injuries, literally hits differently than its Hollywood equivalent.)
I work as a narrative director in video games, and so I play a lot of them. There are very few games in which the player character (what we call the protagonist) would not be in constant pain from the activities we direct them to perform. Even poor Mario would probably be in agony after a single fall from twice his height, an action we order him to do over and over again. If I, say, jumped on a turtle (I would never) I’m sure I would at the very least sprain my ankle.
I remember playing Call of Duty 4 in 2007 and realizing with interest that there wasn’t a health bar to track my character’s physical state. Instead, the screen would redden as I absorbed bullets and shrapnel, but a few seconds spent hiding behind a piece of cover was all it took for the colour to fade away and for me to be restored to fighting form. The agonies that would involve only presented themselves as a brief tinting of the screen.
These games have gotten even more “realistic” in the years since in terms of graphics, sound and even the felt experience of pulling the trigger of a gun, which can now be transmitted to our hands via the controller’s built-in haptic rumblings, uniquely tuned to each weapon’s unique vibrations. But they still don’t, and won’t ever, hurt.
All of these affordances are necessary. I’m not saying we need to see Mario weeping in the emergency room, or Wario’s long months of physical therapy. That would make, at the very least, for very different games. Abstractions exist for a reason. But I do think it’s important to acknowledge what exactly it is that we ignore.
The first challenge in tackling the subject is semantic. Language itself routes around the subject. We have very few words to describe pain; I’m already running dangerously low on synonyms. Is that because physical sensations are ineffable, impossible to put into words? There’s no shortage of writing about food or sex. But those are pleasurable topics we want to imagine, and we’re willing to lean in and make the cognitive leap, even if reading about either comes nowhere near the actual lived sensations.
Not that people haven’t tried1. The late entomologist Justin O. Schmidt devised something called the “Schmidt sting pain index,” which is one of the few examples of writing about pain I’ve come across that manages to be somewhat aesthetic, even appreciative, that explores it on its own terms. Schmidt allowed himself to be stung by various horrible insects (wasps, ants, something called a “tarantula hawk”) and put the experiences into writing.
I think about them a lot. The sweat bee: “light, ephemeral, almost fruity. A tiny spark has singed a single hair on your arm.” The urban digger bee: “almost pleasant, a lover just bit your earlobe a little too hard.” On this end of the spectrum pain and pleasure rub elbows. But as Schmidt subjects himself to increasingly monstrous insects, the descriptions get more wide-eyed and crazed and the fun dissipates. The tarantula hawk in question is “blinding, fierce, shockingly electric. A running hair dryer has just been dropped in your bubble bath.” The warrior wasp: “Torture. You are chained in the flow of an active volcano. Why did I start this list?”
Pain circumscribes not just our ability to describe it, but the world itself. When my pinched nerve was at its worst, I found that every action involved a trade-off. Do I want a glass of water enough to hobble across the room and get it? What would have been once effortless was now an algorithm of unpleasant choices. The world became smaller, until I no longer remembered how easy it was to walk across the neighbourhood for groceries. In a way this is a blessing. It’s amazing how quickly the human mind can adapt to changing or degraded circumstances. But it’s unsettling to watch it happen in real time.
Time also underwent its own dilation and constriction. Pain only exists in the present tense, and when you’re experiencing it it’s impossible to imagine life without its constant distraction. Emily Dickinson is one of the only writers I’ve encountered able, and I guess willing, to describe physical suffering with any kind of accuracy, particularly its capacity to bend the parameters of existence.
Pain—has an Element of Blank—
It cannot recollect
When it begun—or if there were
A time when it was not—
It has no Future—but itself—
Its Infinite Contain
Its Past—enlightened to perceive
New Periods—of Pain.
Whether she was writing about emotional or physical pain, or both, I think the point stands. It is endlessly distracting. A friend asked what the most challenging element of my experience was, and I described it to her as like an alarm that is constantly going off; sometimes loud and right in my ear, sometimes muffled and from next room, but always there.
Even as I write this now, I’m having a hard time recalling these experiences. They’ve evaporated from my memory like dreams. They belong to a different me.
The paradox is that while pain can make us feel like we’re trapped in our bodies, that they’re prisons of meat and bone, it also alienates us from them on some fundamental levels. My physio had me perform what’s known as a “Left Right Judgment Task.” I was shown a succession of images of limbs and asked to identify whether they were the right or left hands or legs. The idea is that affected sufferer’s brains sometimes “forget,” or cut off in some neurological sense, the damaged area, to the point where it seeps into our conscious minds and we have difficulty recognizing it. Almost like a quiet self-amputation.
I used to get pretty bad headaches which would last a few days. I still do, typically a few times a year when the seasons change or the temperature rises or falls precipitously. These used to involve a lot of cancelled plans, evenings spent sitting at home by myself, no small measure of self-pity.
At some point I discovered this Emily Dickinson poem, which at the time I thought I related to, especially the first two lines:
After great pain, a formal feeling comes –
The Nerves sit ceremonious, like Tombs –
The stiff Heart questions ‘was it He, that bore,’
And ‘Yesterday, or Centuries before’?
The Feet, mechanical, go round –
A Wooden way
Of Ground, or Air, or Ought –
A Quartz contentment, like a stone –
This is the Hour of Lead –
Remembered, if outlived,
As Freezing persons, recollect the Snow –
First – Chill – then Stupor – then the letting go –
Re-reading it now, I think I was wrong. It is a beautiful and haunting and weird poem, especially those last lines, which feel like death incarnate in verse. But my “formal feeling” was never quite the same.
What I remember the most about was the emotional state I was in after the pain had subsided, a kind of fragile emotional equanimity, a rawness, my defenses against the world and its insults having been stripped away by the force of pure physical feeling. Not an “hour of lead” at all, but rather the opposite. Emotions felt purer, my heart felt more open, more generous.
These recent months, it’s that feeling of relief that has stayed with me most, moments when the pain ebbs away for an instant and I remember how good it feels… to just feel.
I remember as a kid hearing about the pleasure-seekers in Clive Barker’s Hellraiser series of horror novels and films, who undergo the most grotesque tortures in order to experience the greatest of pleasures, a momentary relief from their agonies2. Relief itself might be the only true pleasure there is: relief from desire, from hunger, from fear.
We love the freezing cold when we huddle by the fire, the burning heat of the summer sun when we jump into the pool. In an early chapter of Moby Dick Ishmael snuggles up with Queequeg in a bed at the inn and observes:
We felt very nice and snug, the more so since it was so chilly out of doors; indeed out of bed-clothes too, seeing that there was no fire in the room. The more so, I say, because truly to enjoy bodily warmth, some small part of you must be cold, for there is no quality in this world that is not what it is merely by contrast. Nothing exists in itself. If you flatter yourself that you are all over comfortable, and have been so a long time, then you cannot be said to be comfortable any more.
All these sensations only exist in relation to each other. Like a dream, we only understand pain in its absence, and by then we’ve forgotten it.
I’m very proud to report that our fundraiser for Doctors Without Borders was wildly successful, having raised $5,330, way beyond our initial $2,000 goal. The bookplates are now at the printer and should be ready to mail out shortly, hopefully in mid February. Thank you to everyone who gave.
If you missed it, we are reading Patrick Leigh Fermor’s A Time of Gifts over at, our travel-focused book club spinoff. The book chronicles the then-18-year-old’s 1933 walking trip from the Hook of Holland to Constantinople, and was written more than 40 years later, after Fermor fortuitously discovered his travel diaries in an ex-girlfriend’s Moldovan castle. Here’s a passage I recently enjoyed, describing what it felt like for him to bunk down in a barn on a snowy night, an Ishmael without a Queequeg:
When I was alone I stretched out on a bed of sliced hay like a crusader on his tomb, snugly wrapped up in greatcoat and blankets, with crossed legs still putteed and clodhoppered. Two owls were within earshot. The composite smell of snow, wood, dust cobwebs, mangolds, beetroots, fodder, cattlecake and the cows’ breath was laced with an ammoniac tang from the plip-plop and the splash that sometimes broke the rhythm of the munching and the click of horns. There was an occasional grate of blocks and halters through their iron rings, a moo from time to time, or a huge horseshoe scraping or clinking on the cobbles. This was more like it!
It’s never too late to join us over there. Come join the club.
This week’s #nojacketsrequired comes courtesy of me. I’m reading this great book by game designer and academic Frank Lantz, who beautifully expresses ideas about the aesthetics of gameplay I’ve long grappled with but had never found the words for. The chapter on Go alone is worth the price of the book.
When we think of the charge of escapism often leveled at videogames, we picture vivid imaginary worlds and wish-fulfilling power fantasies. But there’s another way that games can be escapist. Thought is painful, our minds are cluttered with the endless chatter of consciousness, and Go is like a single note, a pure tone created by striking this tiny corner of the universe, and it reverberates forever, filling your mind with something like silence.3
And look at that gorgeous orange cover!
As always, send me your own discoveries.
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And, in fact, the history of European art is full of stigmata and spear wounds, but outside the cinema of Mel Gibson and horror directors, we don’t dwell on them nearly as much as we used to.
I think I misheard this, or at least misremembered it, as I can’t find any evidence of this particular idea, but I still thought about for a long time.
Ursula K. LeGuin: “Fantasy is escapist, and that is its glory. If a soldier is imprisoned by the enemy, don’t we consider it his duty to escape?”