Mind Your Pain

After two weeks of no exercise and pretty much sitting for hours on end trying to meet a deadline, I step onto the track reluctantly. My brain tells me I should be out partying over successfully beating the deadline, not dragging my inertia-laden body to the gymkhana for my evening run. One kilometre into the run, I know I will find my rhythm, in the thrum of my heartbeats riding the wave of my breath, the slight jar of the ground rising to meet my feet, travelling through my legs, in a familiar, pleasant shock. But in the meanwhile, the reasonable brain is the one to beat. Exercise is always mind over matter and the mind is the frenemy, the beguiling voice that asks you, won’t next Monday or next month or next year be better to begin a new fitness routine?
Newton will have you know that an object will remain at rest unless acted upon by an external force and in a bid to crack the ultimate philosophical conundrum of who is the force and who is being forced, I push myself to run.
The very next second everything goes black. I open my eyes to find myself on my back in the middle of the running track, the sky obscured by several faces indistinguishable in the darkening evening and inexplicably, my face seems wet. The wheels begin to turn, the brain finally has something to chew on. It couldn’t have rained it deduces, unless I have been in coma from December to June. A moment later the riddle is solved as a girl liberally sprays my face with water from her water-bottle. Some of it goes up my nose and now open eyes. Really people, stop relying on Hindi films for first-aid training. I sit up, thoroughly embarrassed to be the much reviled damsel in distress and refuse all offers of transportation to the nearest doctor. Someone offers their hand, I ignore it and push myself up. Halfway up, my knees buckle and an incredible amount of pain shoots down my left leg. But I still have an audience and an unrelenting ego, so I grit my teeth to dust and hobble slowly towards a waiting auto rickshaw. In my mortification and a desire to be left alone with my pain I rudely brush aside the concern of fellow humans. The bouncy ride home is something I will not forget in a hurry.

One of the principal qualities of pain is that it demands an explanation ~ Anne Carson, Plainwater

As my foot struck the ground the specialized pain receptors in my skin decided that all was not well and they carried that information to the spinal cord via the peripheral nerves. The spinal cord agreed that all was indeed not well and carried the information to the brain for further analysis. Now the spinal cord itself is a bit of a control freak. While the brain is connecting and confabulating with different parts of itself, thalamus, somatosensory cortex, prefrontal cortex among others to analyse the information, a reflex response occurs within the spinal cord. Say you touch a really hot object, your motor neurons are activated and the muscles of your arm contract, moving your hand away from the hot object. All this happens way before the brain comes up with, ouch, I know that pain, she must have touched a hot stove, she’s always so clumsy, her mother never loved her, she must eat copious amounts of chocolate and cry.
In my case something even cooler happened. The damage was bad enough for the body to require to stop moving immediately. Consequently, the vagus nerve was stimulated which reduced the blood flow to the brain causing me to keel over.
We think we feel the point of pain at the exact spot we are hurt, but actually all pain is in the brain. The nerves send signals up and the brain interprets those signals based on past experiences, emotions and deductions, and relays that information back to the nerves.

I think about the meaning of pain. Pain is personal. It really belongs to the one feeling it. Probably the only thing that is your own. I like mine. ~ Henry Rollins

The three flights of stairs up my apartment feel no less than Mount Everest this evening. For someone whose idea of medicine is Arnica 200, I have never been more happy to find one lone strip of Ibuprofen in a medicine cabinet full of tiny brown bottles filled with sugar pills. Two Ibuprofen 400 later the pain is blunted enough for me to be able sleep for a bit. Until I wake up in the middle of the night to pee and then the insistent screaming begins in earnest, again. No woman has felt more penis envy than me in that moment. Sitting on the pot feels like I am being lacerated by a sharp knife, getting up and pulling on my pants is the knife was being twisted within. Two more Ibuprofen later, I cry myself to sleep.
Imagine being trapped in a soundproof room with an orchestra sans a conductor, playing 24/7. Sometimes all the instruments, woodwind, string, percussion explode into action simultaneously in brutal cacophony. Sometimes it’s just one solo violinist playing the same screeching note over and over. There is no leaving it, no one can reach you. In my case there is no wound, no external sign, bandages or cast of any sort as proof of my hurt. I am completely alone, immobile and suffering my pain.
Pain is the one single commonality we share with all sentient beings on this planet. Yet it is also the most isolating, the most lonely experience. For no two people experience pain the exact same way.
As a testament to my monumental stupidity only matched by the size of my ego, I wait a couple of days and only when the pain, to continue with the musical analogy, threatens to explode into the next octave, I drag myself to the world’s most unimpressed orthopaedic surgeon. Dr. P specialises in replantation or reattachment of severed limbs. Unless I had stood in front of him holding my severed right hand in my left and a stump of a right arm spouting blood at him, he wouldn’t have looked up from his prescription pad. But perhaps something about my voice and, more importantly, my refusal to sit draws his attention. After my recap of the events and a ‘tch’ of annoyance at me having waited so long to come see him, the good doctor comes up behind me and asks me to bend forward and pronounces with no irony whatsoever, “Oh my dear, you are screwed”. He concludes that my sciatic nerve is pinched between two vertebrae and my spinal cord “is a goner”. He recommends a week of complete bed rest and then adds the words that I would have sold my first-born for, “Let’s get you something for the pain”. I eagerly anticipate a giant injection, the kind they inject horses with or a tranq-dart that forest rangers use to bring down rogue elephants. Instead, a minion appears with a small, square transdermal morphine patch which the doctor slaps on me, just below my left collar bone. ‘This it?! Where’s my injection?’ I ask in my best druggie-Sridevi-in-Jaanbaaz impression. “Oh, I send my surgery patients home with just this patch, says the back-to-being-uninterested Dr. P. “You’ll know what I mean in twenty minutes”.
Twenty minutes later, I could have run home. I didn’t. But I could have.

And now my beauties, something with poison in it I think, with poison in it, but attractive to the eye and soothing to the smell . . . poppies, poppies, poppies will put them to sleep.”
~The Wicked Witch of the West, The Wizard of Oz (movie, released 1939)

Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal as opium ~ Thomas Sydenham

Morphine was first isolated from opium in 1803 by Frederick Wilhelm Adam Serturner in Germany, who named his creation after the Greek God Morpheus. Morpheus’s father was Hypnos, the God of sleep; his mother Pasithea, was Goddess of R&R, his grandmother was the fearsome Nyx, Goddess of Night and all things mysterious and inscrutable. Morpheus and his spooky family resided in the land of the dreams that was flanked by the river of oblivion and the river of forgetfulness. At night Morpheus and his brothers would emerge like a flock of bats and carry forth dreams and nightmares and premonitions to the sleeping mortals. Morpheus slept on a bed of poppy seeds, perhaps the reason why Serturner named his drug Morphine. Poppies have long symbolised eternal sleep and oblivion, and to be in the arms of Morpheus meant sound sleep.
Legend has it that the Buddha in a fit of rage, ripped off his eyelids to prevent himself from falling asleep while on the non-violently meditative path to Nirvana. Where the eyelids fell, there grew a small herb that bore a nodding purple flower, the Poppy. From about the time humans were inventing the wheel, they also figured out that the aches and the general ennui that came from chipping stone and chasing off woolly mammoths and sabre-toothed tigers on a daily basis could be undone with a sip of Poppy juice. Opium finds mention in ancient Sumerian literature as the first recorded use of a painkiller. 6000 years later, its derivative Morphine and its ugly step-sisters Codeine and Heroin are regularly eulogized in popular culture. They are couched in metaphor and trope but we always know what they are talking about. We knew Lucy In The Sky was about The Beatles experiment with controlled substances, even though no one explicitly told us about it. And we can safely assume that the Canadian singer The Weekend in his hugely popular 2015 hit single, ‘Can’t Feel My Face’ hasn’t composed an ode to his dentist’s skill with lidocaine.

That’s what opium does to suffering: makes it of hypothetical interest only ~ Sebastian Faulks, Engleby

If it wasn’t for the still current memory of the pain and the strict instructions of bed rest with the threat of hospitalisation looming over my head, I would have considered myself completely recovered within the first hour of the patch being stuck on my skin. There was such a sense of well-being that enveloped me, I was practically euphoric. I have never cared for alcohol or weed and have always felt slightly superior about not needing Dutch courage. But now I believe that there is a perfect drug for everyone and morphine is mine. And it came with the blessings of a most powerful authority figure in civilized society, The Doctor.
I remember a conversation with X, a dear friend who came to visit. X has been having an exceedingly difficult time dealing with a sick child, compounded by a failing marriage and as she began to weep, a distinct thought floated through my head, ‘Who gives a fuck…’. A thought like that, even a single errant thought, if it had ever come to me pre-morphine, would have been followed by a wave of self-recrimination, it would have been really hard to forgive myself. But now, nothing. Blissed out nothingness. Even my own troubles, financial, health issues, emotional issues, I could see them, standing huddled at a distance and I felt nothing. A very perceptive friend told me over a telephonic conversation how different I sounded. The only time I really felt deeply for anything, was for my morphine patch, I pulled down the neck of my T-shirt to show the patch to everyone, I slept every night with my hand over it. On the 5th day of wearing the patch, I was watching a film, an old favourite, P.S. I Love You, and it moved me to tears as it always does. And then I began crying in earnestness, because it occurred to me that my holiday from feeling anything was over. The morphine had left me; I knew exactly how Gollum felt upon losing the One Ring in The Lord Of The Rings, “It came to me. My own. My love. My own. My Precious. Lost! Lost! My Precious is lost!”

Being human is a condition that requires a little anaesthesia ~ Freddie Mercury’s character in the 2018 film Bohemian Rhapsody

Just as pain is a prison, so is morphine. In many ways they are the perfect study in contrasts. If in pain you are trapped in a prison of feelings, then morphine gives you a penitentiary of numbness.
Opioids like Morphine and Heroin target the brain’s reward system by flooding the circuit with dopamine and endorphin. And we are awash with feelings of well-being, euphoria, achievement. Our brain naturally produces small amounts of these neurotransmitters when we do fun things like make love, kiss our babies, exercise, count the likes on our profile pic etc. But not in the quantities offered freely by opioid derivatives, without having to do a thing to deserve those sensations. Our brains are easily impressed with feelings of the good kind, pleasure and reward and take serious note that something important is happening and remember it and want us to repeat it, repeatedly. Except that after a while we need bigger and bigger fixes to feel the same level of high. Interestingly, it isn’t the promise of the rewards that makes people seek more of the same drug, it’s the fear of the withdrawal, the depression, the insomnia, the inability to feel good naturally once off the drug that leads to addiction.
However, even with all the risks, Morphine is the most effective painkiller still. Aside from the feel-good aspect, it also blocks the pain signals from travelling up to the brain. It is the preferred palliative for people in severe, chronic pain. As my BFF lay dying from end stage metastatic cancer, morphine completely transformed the last year of her life, she became the beautiful human she had always been before the debilitating pain of metastasis in every organ of her body, including her bones had reduced her life to an endurance test. She was able to spend the last year loving and being loved by her near and dear ones, just the way she would have wanted to.

You take the blue pill, the story ends. You wake up in your bed and believe in whatever you want to believe. You take the red pill, you stay in Wonderland and I show you how deep the rabbit hole goes ~ Morpheus’s character in the 1999 film, Matrix.

These iconic words were said to Neo ( Keanu Reeves) to help him make a choice if he wanted to live the known life in accordance to the false constructs prepared by the machines or to take red pill and walk into a world of uncertainty where his death and the complete annihilation of the human race was a certainty, but at least the freedom of choice would be his, to die the way he chose. It is speculated that the makers based it on the allegory of Plato’s Cave which describes a group of people chained within a cave all their lives and thinking the shadows formed on the wall by a fire their only reality, until they manage to break free and discover the sun and the world outside their prison. But freedom is not always what it is made out to be, someone who has who has never seen the sun would find it painful and would want to return to the safety of the cave. Indeed, in Matrix, Cypher who ultimately sells out Morpheus and his band of rebels to the machines regrets that he made the choice of taking the red pill saying, “Ignorance is bliss”.
At the intersection of choices of blissful ignorance and pain of human existence lies the Buddhist philosophy of Mindfulness. If everything is in the brain, then in the mastery over the brain lies our salvation. Both happiness and suffering are liars. And qualifying one state as good and the other as bad is a fallacy. Mindfulness has rapidly become the favoured therapeutic intervention to alleviate chronic pain, stress, insomnia, depression etc.

Now it is well known that when there are many of these flowers together their odor is so powerful that anyone who breathes it falls asleep, and if the sleeper is not carried away from the scent of the flowers, he sleeps on and on forever. But Dorothy did not know this, nor could she get away from the bright red flowers that were everywhere about; so presently her eyes grew heavy and she felt she must sit down to rest and to sleep. . . “If we leave her here she will die,” said the Lion. “The smell of the flowers is killing us all.”
—Excerpt from The Wonderful Wizard of Oz (book, published 1900)”
Fortunately for me the morphine had a time limit of five days.The back pain is vastly reduced and I’m well on my way to recovery and hopefully back to my old routine of finding my happiness fix through ‘natural means’. Or finding the acceptance that there are no permanent fixes.
My brain recalls the five days under the influence of the little patch of poppies as the happiest I have been. It was a good trip. But now I’m back to walking the yellow brick road of life, hoping to find my way back to Kansas. Sigh.

(My article on pain as it appeared in Feb 2019 edition of The Man)

3 thoughts on “Mind Your Pain

      1. One more kinda compelling fact – there’s one food that gives us a feel for morphine right out of the womb – mammalian milk. It’s just soo intriguing to me how He thought it out so well to not leave our survival to chance and used morphine to draw us in. ( Oxytocin for mom and morphine for baby … reminded me of your other post mom and your new baby sis)

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