Wednesday, August 8, 2018


A midsummer's reflection on pain, and freedom from it.

It's been a while since I've posted anything on the blog. It's certainly not for lack of what to talk about. The Ontario election produced a majority Conservative government that's wasted no time in doing what politicians do, namely reneging on promises for no good reason and shamelessly attempting to buy voters' affections with policies that defy sense (common or otherwise). Canada's teaching hospitals face a looming manpower shortage as a consequence of the spat with Saudi Arabia. And for good measure, the world is quite literally on fire.

No, the reason I've been relatively quiet on the digital front is that I've been recovering from surgery for chronic pain. The entire episode lasted about two years, give or take, and as I counted down to the surgery date I was clearly getting close to a breaking point. Pain is a form of prison all unto itself. It robs you of your sense of independence, your social activities, your energy...your ability to enjoy much of what there is in life worth enjoying. And unlike a life-threatening disease, pain won't garner either sympathy or attention for very long. After all, everyone gets pain, and everyone has to learn to cope with it...what makes me different from anyone else? And as for what chronic pain does to your mood and mental's both toxic and unpredictable, and can flip from one state to another in an instant.

The good news - no, the fantastic news - is that the surgery was a success by any measure I can think of. Physically, I feel better than I have in many, many months. I'm walking without pain, sleeping without pain, and can do most of my work and household chores without difficulty. For a real change of pace, I'm now more comfortable standing than seated. (What do you call a couch potato that can't tolerate being on the couch? I'm not joking...what should I call myself?)

You could almost say I feel reborn. It's an apt metaphor, but not for the reason you might think.

Like a newborn, I did not emerge from two years of pain feeling ready to take on the world. I'm still a far cry from my physical peak of a decade ago, before my first go-around with chronic pain. I'm faced with many more months of work to get my strength and energy back to where I need it to be, if I hope to feel anything less than 20 years older than my chronological age.

The hardest part of getting better, though, is rebuilding my life outside of my body. Just as it is with depression - and one more reason why they're so closely connected - pain keeps you tethered to loneliness, withdrawn from the people that matter. Your time becomes ever more "free", as you can do less and less, but it's not time spent enjoying the company of others...rather it's time spent ever more alone in your own head. While spending my time in pain as I did, I lost touch with a lot of people I was incredibly close to. Some of those relationships will bounce back, others have faded into the background as old friendships often do, and still others - connected to activities I'll never be able to get back to - are gone for good. Fun as it will be, it gets harder to build a life the older you get. And truth is that it's scary as hell to escape your own misery, only to discover there's nobody around to share in the joy.

It hasn't escaped me that I've been very, very lucky. Twice I've been miserable and crippled with pain, and twice I've recovered faster and more completely than expected. But many more people out there, including many patients I've cared for in years past, haven't. And while medicine gets better and better at curing patients of their pain, and grows more and more conscious of function beyond a crude "out of 10" pain scale, we too seldom get a sense of how the patient is actually living. When I think back on those patients whose pain was unyielding - often the victims of trauma - I lament that I never gave it much thought. It's a mistake I hope not to repeat in the future, and I suspect I'll be a much better doctor for it.

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