I’ve been in pain. It’s been almost year now. It’s not significant, it’s not crippling, it’s just there. Every day. Today I want to write about it.
But let me start with a paragraph I started writing before I swore at myself:
So, the pain started about a year ago. It travels a bit, but it’s limited to the upper body. Its intensity fluctuates. Sometimes it’s stronger and I am aware of it, sometimes I am not so much, I need to stop and think about it.
Yes, that’s what I had written before I noticed what I was doing. I started swearing at myself for writing about this abstract ‘pain’. No, there is no pain, no, I have been hurting, my body has been aching. I’ve suffered, basically. And yet, for one reason or another, the way I started writing about it distanced me from the suffering, as if I were supposed to describe this object somehow separate from me. I don’t know why (well, I have an idea, but it’s for a different blog).
But the reason I wanted to write this post is different. First, I want to write about my experience of reporting my pain to doctors, second, a linguist in me wants to write a little bit about pain scales.
So, if you wait for some sophisticated account of narrative vs medical model in my pain reporting, I’m sorry to disappoint. Nothing. Nada. Zilch. No mater how many times I said I was in ‘some pain’, there was no reaction. Nothing. I suspect it was because I left till later in the story, or because I was not reporting it in any distress. Or there were so many more important things for the doctor to consider, surely, that the pain somehow got lost.
Why did I not press the issue? I once did, I started shouting about it. It turned out that even though I had been telling the medic about the pain for months, he actually didn’t even notice it! In fact, he challenged me that I had not mentioned it before. My response didn’t go down very well. And so, I guess, after a while I decided that I needed to continue hurting. But then it is not very difficult, it isn’t crippling. It’s just there.
But I started wondering about the reason why this ‘insignificant pain’ is blanked. Obviously, there are many possible answers, but I want to suggest one of them. You see, I started looking at pain scales. And, if you forgive the pun, it’s been painful. Bloody hell, some are stupid. Let me show you one of such scales; if you google pain scales, you will find plenty of others very similar to the one below:
I looked, and looked and then I went to look for my jaw. It’s awful!
There are too many things wrong with it to give justice to here, so let me just mention two. The first, and probably obvious, is the idiotic smiley face up until level 3. I wonder whether the author of this nightmare of a tool has ever been in pain. Are you really saying that I am just smiling about my pain? Generally happy, after all, nothing is happening, I’m just over level 2, so who cares? Bring on more? To be completely honest, when I looked at the scale and others like it, I felt slighted, insulted, upset. Are you really saying that any pain is something to smile about? Really?!
And so, it hit me. Why would a doctor ask about a condition represented by a smiling and happy face? No, it’s not as happy as the no-pain face, still it’s happy enough. Nothing to consider. Just live your happy life. In happy pain.
For me a sad face and, say, red colour should start at level 1. Green, the ‘it’s OK’ colour has no place there. It should get darker, more intense, as you go along, but we should start with sad red. And here is my main problem. The scales, it seems, start with severe pain. That’s the benchmark. Level 1 pain, when compared with the high end, does indeed look insignificant and unproblematic. Nothing to talk about. And yet, I would humbly suggest that you should reverse the order. Start with insignificant pain, the high end of the pain spectrum will still be as unimaginable as it gets and it will not be undermined by my ‘little pain’. But, please, don’t assume that just because mine is not something you see fit to talk about, I cannot cry about it.
So, here is my account of insignificant pain. Should the doctors have done anything? I have no idea. But I still would like to be able to talk about it. I would like the medic to notice and acknowledge that I suffer, even if nothing can be done. After all, if I cannot talk about my suffering even to my doctor, then perhaps it is time for a computer GP. At least my expectations will be considerably lower.