On Pain
My throat hurts and I want to talk about it
Right now, I am in pain. Most of the time on Substack I think that sentence would be coded as mental pain, but this is something animal. My throat has again been infected with the same disease that started my last post. It has lasted longer this time, and its peak (knock on wood) was worse. This is an infuriating abnegation of responsibility on the part of my immune system, whose whole deal is supposed to be getting better at fighting the same battles. Though clearly it is working overtime as my tonsils are brimming, 24/7 with what the doctor called “exudate.”1 To me exudate looks like wet, moldy, evil cheese, but I’m told it is evidence of the immune system in action.
The doctor said it is not strep throat. She also said it is not mononucleosis. Your guess is as good as mine. But she did give me these steroids (prednisone) to keep my throat nice and open for breathing purposes. Thing is, they gotta be taken with food, so for fifteen minutes this morning I ate tiny portions of a banana, tearing up and cringing with each swallow.
Two days ago, through intermittent migraines, all my thoughts were about the pain. I had cancelled all my plans and was ignoring all my responsibilities, it was too hard to concentrate on reading, too much even to look at a screen. I was not exhausted or sad, just in pain.2
It alleviated somewhat in the afternoon, as it has tended to do. I went to the balcony of my parents third floor condo, the old tree that surrounds the balcony looked like it was rimmed in gold and the wind and the people below felt so vital and so real. I cried because I had so much to do and couldn’t make myself do anything, because I had promised to be places and couldn’t go to them, because I felt so useless, and felt like the pain was just revealing who I really am if you put anything meaningful in my way. Self-obsessed, ineffective, instinctual, prevaricating. Pitiable but not admirable.
Because the pain has been hard, but, reader, it isn’t terrible. It was take Tylenol as often as you can bad. It was not take opioids bad.
My grandma got back surgery last Tuesday, was in the hospital until Friday, and now is back home. Someone split her open and quite literally rearranged her spine. She has opioid level pain. Still when I texted her she said her brain fog was lifting and that she could now enjoy her fascinating puzzle. Quote: “I am spoiled!” To be that gracious…3
Nevertheless, one’s own pain is a totalizing thing. It pinches at your brain, pokes at your eyes, rings in your ears. It will not let you go. Pain like this reminds me how profoundly unheroic I am, how basically selfish. Part of me wants to be like Boromir at the end of The Fellowship of the Ring, riddled with three arrow but shrugging off the pain and still single mindedly focused on saving the hobbits. In reality if I were in his situation I would have been hit with the first arrow and thought “ah, fuck, an arrow,” and that would have been that, hobbits be damned. In pressing through his pain Boromir makes us admire him. But I’m not sure what I take from that, and I’m actually usually pleased I don’t have a Boromiric bullishness.
All pain provides a basic form of meaning. A useful one. It says, stop that you. That is bad. Slow the fuck down. This is the message of the stubbed toe to the mind of the stubber. However, with most physical pain, once you have clocked the message you are done. You must wait. And in the future if you stub your toe your body will send the same message. Dude, just why? But you will do it again. Because you are a clumsy guy. Yet all levels of physical pain deny us narrative.4 A stubbed toe is a ready-made pariah. It has no social context, implies no moral duty. When we imbue great physical pain with meaning it is often vulgar. Think of when the child with leukemia is called an inspiration. In pain it often feels there are only heroes “despite”, not heroes “because of.”
The distinction there may be overdrawn, but what I’m trying to say is that pain totally saps agency. It is the anti-liberator. Destroying narrative and chaining us to our physicality. This occurs in some obvious ways. If I try to eat, the food touches my throat, and my throat screams. I am not at liberty to eat as I would like. If I speak, my throat quickly becomes sore and worse. Besides I sound like a dying frog, or in the words of my roommate “like an announcer from the 1940’s who I’m listening to on a broken record player.” I am not at liberty to speak as I would like.
It is less obvious why I can’t work. Why I find it so hard to read. Why until this afternoon it would have been impossible for me to write this. The answer is that agency is a kind of output, it is something we produce by choosing between different ways of being. The necessary input of this process is attention. Attention is not a way of acting on the world. Attention determines what the world is for us. It makes new worlds possible.
When I am in pain, it demands my attention stringently. It limits my ability to construct a rich and vibrant world. It turns me inward, a place I already go too easily. I lose first the extraordinary and holy ability of attention to briefly make other people the main character of your life. As Simone Weil writes, “… it is indispensable to know how to look at [the afflicted] a certain way. This way of looking is first of all attentive. The soul empties itself of all its own contents in order to receive into itself the being it is looking at, just as he is, in all his truth. Only he who is capable of attention can do this.”
Weil was a true master of attention and not a stranger to pain. Yet somehow in her pain she found forms of attention and communion with other people. I would rather be Weil than Boromir.
If I may be allowed to brag. I looked up “tonsillitis exudate” online (do not do at home) and even by the standards of the gory google medical images my exudate levels were… rather prodigious
I wrote these first two paragraphs in the morning when the pain level was high, the rest in the afternoon when it went down. Otherwise the rest never would have gotten written
My mother drove four hours to spend a couple of days with her this weekend. My mother is a physical therapist, so this was exceptionally helpful. To be that gracious…
Mental pain is slightly different, often thought to be instructive and relatively easy to slot into an idea of progress. I am somewhat suspicious of this notion. It is unclear to me that fear, sadness, anger, and trauma make us deeper when overcome. Certainly not by necessity, perhaps by hard work, though so much hard work is circumstance. (Can you afford a therapist right now?) Nevertheless, mental pain furnishes us with all kinds of interesting narrative elements. At least up to a point. One manifestation of grinding depression, as I understand it, is the absence of meaning beyond which you can connect nothing with nothing. As Susan Sontag said, “melancholy minus its charms”.