Pain Management

At an annual visit to her doctor, just as she was shifting downwards on the table, the physician gently asked, “How is everything going? Have you had a good year?”  Tears streamed suddenly with abundance, surprising the woman who’d walked in that morning cheerful and upbeat. This was happening more and more. At the first sign of tenderness, an unraveling would begin, and the inner workings of her heart and mind would emerge without warning, neither summoned nor welcomed. Earlier in the week, a similar response occurred when a friend checked in with a simple “thinking about you.” 

Pain resides just below the surface. The woman tricks herself into thinking otherwise. As a means to survival, this is key. How else could she move through her days and life so assuredly? Convinced it exists deeply in the recesses and corners of her interior she manages to do her job, take care of her pets, cook the meals, get in her workouts, fill her tires when low, remember birthdays, pay bills, be solid for her children, laugh with her friends, and love her family. In other words, believing she’s managed the pain is how she gets shit done. 

But she knows better. She knows that pain, while skillfully camouflaged, is hiding in plain sight. Like a barely hardened scab, a simple tug at the edges can reveal an oozing wound, as raw and tender as the day it was born. Her skin is thinning as she ages, rendering those scabs less protective. Useless armor, her pain finds the weak points, coming at her knees, her elbows, her groin. Not one to turn away from the present state of mind, she searches for paths to manage this changing reality.

Home from the doctor, she reaches for understanding. She wants a ticket into whatever might be brewing behind consciousness. A few deep breaths and with the last exhale she steps inward. Admission is free but beyond the curtain, the space is cluttered, dark, and murky. Arms extended with open palms she steps carefully through, eyes wide and adjusting, readying for whatever decides to show itself. There is a lot to take in.

There is no order to this pain. It’s not cataloged neatly, though it could be. She knows how to line it up and has been doing so for decades. Keeping a chronology of grief can help foster a sense of control. This has helped her through the decades as she set goals but faltered, experiencing her losses like literal roadblocks to moving forward. But today any semblance of tidily arranged anguish has vanished. Today is a jumble, and she commits to clumsily bumping into the wounds and embracing the aches that come with it. 

The past hurts bleed into present fears. She sees her mom, gone too young, looking from one daughter to the other, her eyes filled with the fear of knowing she is leaving. Just behind lies a baby in a hospital crib, tubes from his chest, experiencing pain that some people go a lifetime not knowing. Absorbing this tableau, she turns to another, witnessing the bracing heartbreak of the long-ago tragic loss of her father leaning headlong into the worry for her child whom she currently feels incapable of helping. The woman watches all of it and more, willing it into her veins, fighting with every ounce of her being the urge to turn and run. Eyes closing, the pain courses through her and she stands arms long, legs wide, giving in to its power and strength. Resigned to it having its way, she takes the leap and for a time, she is gone. 

Her eyes open, and the woman curled on the floor, is spent. Her body is exhausted from embracing what she’s neglected for too long a time, and her hair and face are slick from sweat and tears. Shuddering and depleted, she picks up her head to find herself out of the darkness and back in her room. She seems surprised to find herself there as if falling forever into a chasm of despair had been possible, forgetting she possesses resilience and will. As she stands she remembers. She has been there before, in that space that is dark and holds all of the hurt. She will be there again. She knows she must. She will always go. This is pain management. This is survival.