Monday, December 30, 2013


I’m trying to read The Body in Pain by Elaine Scarry, “which is known as a definitive study of pain and inflicting. She argues that physical pain leads to destruction and the unmaking of the human world, whereas human creation at the opposite end of the spectrum leads to the making of the world.  “Elaine Scarry (born 30 June 1946), a professor of English and American Literature and Language, is the Walter M. Cabot Professor of Aesthetics and the General Theory of Value at Harvard University. Her interests include Theory of Representation, the Language of Physical Pain and Structure of Verbal and Material Making in Art, Science and the Law.” 

The book has been kicking around my selves for a long time and I’m trying to get a handle on what I should cull.  This book is pretty heavy duty, but looks at pain in four realms: medical, the state (torture), religion and creation.  As far as I’ve read, she is asserting that pain means diminishment, erasure, control, and the illusion of power.  She is not considering sex (S/M as a form of intimacy) nor birth as intimate creative pain.  She’s writing in 1985 and these contexts were not quite welcome yet, the African atrocities not quite known.

In fact, I’m going to take a little detour as well.  In the medical context, Scarry mentions the “McGill Pain Questionnaire” which is a breakthrough diagnostic tool that tries to overcome what she calls “the inexpressibility of pain.”  Since I’ve been wrestling with a sore shoulder, I’ll see if I can make it personally relevant.  The idea is that the clusters of words are suggestive of kinds of pain and are in sequence from left to right in terms of intensity.

Sample questionnaire

Flickering, Pulsing, Quivering, Throbbing, Beating, Pounding
Jumping, Flashing, Shooting
Pricking, Boring, Drilling, Stabbing
Sharp, Cutting, Lacerating
Pinching, Pressing, Gnawing, Cramping, Crushing
Tugging, Pulling, Wrenching
Hot, Burning, Scalding, Searing
Tingling, Itchy, Smarting, Stinging
Dull, Sore, Hurting, Aching, Heavy
Tender, Taut (tight), Rasping, Splitting
Tiring, Exhausting
Sickening, Suffocating
Fearful, Frightful, Terrifying
Punishing, Grueling, Cruel, Vicious, Killing
Wretched, Blinding
Annoying, Troublesome, Miserable, Intense, Unbearable
Spreading, Radiating, Penetrating, Piercing
Tight, Numb, Squeezing, Drawing, Tearing
Cool, Cold, Freezing
Nagging, Nauseating, Agonizing, Dreadful, Torturing

The list neglects the psychological “pain” that accompanies physical pain: the anxiety, the dread, the guilt or shame, and so on, but it's only a sample.  I consulted our clinic nurse practitioner who says it is either atypical arthritis, atypical carpal tunnel, or atypical fibromyalgia.  Typically unhelpful.

My shoulder, which is not THAT painful, since one adult dose aspirin will give me relief, but it is not just my shoulder.  My hands and arms have also been involved.  In fact, I’ve about come to the conclusion that I’m dealing with a complex.  First is tunnel carpal, which is not surprising since I keyboard all day.  But it’s the mousing that radiates clear up the arm to the shoulder.  If I stumble along with left-handed mouse use, that gives my right shoulder some rest.  Tunnel carpal, as I understand it, is when the tubes and wires that pass under the bracelet of binding tendon at the wrist joint are so swollen by use or inflammation that the wrists are painful, as mine are intermittently.  Twingy.

My thumbs feel sprained.  I don’t text but I notice that I’ve developed the habit of twirling my thumbs.  My mother did this, too, and once in church was so intensely twirling that I reached over and held her hands, which made her cry.  I wish I could remember what the topic of the sermon was, but I’m not sure I was listening.  To keep from twirling thumbs, I’m reminding myself to keep my hands entirely separated.

My arms, but particularly forearms, went through a period when they felt lamed by overuse, as though I’d been lifting a lot of heavy things.  When I brought in my monthly load of groceries, this was intensified, since the cat food and bottled water come in case lots.

Years ago the actual shoulder was identified by a doctor as slightly damaged so the joint occasionally pinches a nerve.  It’s clear that this comes from carrying a bag of books with that arm since high school (no backpacks in my day) and from many many miles of driving with a stickshift, steering with only my right hand at the top of the wheel.  Doctors all over Montana are eager to replace joints but I shall fend them off.  Nor am I enamored with the idea of physical therapy. 

So the pain here is an overlay: some pinching, some twinging, some limpness (my hands are sometimes clumsy), annoying, and -- when the shoulder is at its worse, burning.  “Milwaukee Shoulder Syndrome” comes up on the computer.  Here’s the description:  “apatite-associated destructive arthritis is a rheumatological condition similar to calcium pyrophosphate dihydrate deposition disease (CPPD). It is associated with periarticular or intraarticular deposition of hydroxyapatite crystals.  Though rare, it is most often seen in elderly females beginning in their 50s or 60s.”

Mercy!  But all these big words are only descriptive.  Clearly minerals, in this case calcium, can crystallize and accumulate at the joints, putting “sand” in the lubricants and giving a person grinding sensations.  The suggestion is that getting the balance of calcium and magnesium right would be helpful.  I drink so much milk and eat so much cheese, I might be triggering the problem with diet.  If I emphasized foods with magnesium  (beans and nuts, green leafy veggies, brown rice and whole grains -- all of which I like and eat) I could make things better.  I’ll get out “Diet for a Small Planet” and use it, which I’d been meaning to do anyway.  In summer, when there were a lot of fresh green leafy foods around, I was fine.  So now it’s time for the slow cooker.  My muffins already contain enough berries and nuts to make a squirrel chortle.

Here’s another thing to think about.  On the back of my shoulder, about the same time that the pain started, is a bite of some kind that itches enough for me to have scratched the top off several times.  Spider venom?  Tick fever?  Last night I took a .222 (thirds @ of aspirin, caffeine, and codeine) instead of an aspirin and woke with enough pain to think about the Internet conviction that female heart attacks are in arm and neck.  Mental torture.  But as soon as I got up and moved around a bit, the pain was gone.  Vascular?  A circulation problem?  Just the pinched nerve?

Are you fed up with this yet?  The one friend in whom I confided soon objected.  We mock old people for complaining, real though it may be, and we hint that it may NOT be real.

The internet sources recommend expensive blood testing which I’m sure would please the local medical community if only for the profit margin, but also because that’s the way they like to do medicine: by equations in a lab with no groaning people present, whinging over atypical sore shoulders.  Now that we’ve discovered that human beings are actually complexes of molecules that can be converted to numbers, we are “bookkeeping our blood” the way money is a matter of double-entries and, in fact, interchangeable with money.  The perfect justification is there for diminishment, erasure, control, and the illusion of power -- we all become walking test tubes and our bodies are no more than collections of titres to be adjusted.

Pain can help with diagnosis, but not this kind of twitchy complicated low-level small stuff -- yet this is almost the nature of old age and chronic disease.  No one wants to hear about it.  Even friends will have “magic cures” that they thrust upon a person, favorite theories that they propose and if they don’t work, they're irritated with us.  Some cures are far worse than the original problem. -- consider chemo for cancer and antiretrovirals for HIV.  Is it the pain, the cause of the pain, or the attempt at cure that is dehumanizing?  There is definitely a political element here.  Back to Scarry.


Rebecca Clayton said...

I've had trouble with repetitive stress injuries for the last 25 years or so, and I wonder if you might be hurting yourself in some of your normal routines. If you can stop hurting yourself (subtly, so that you don't notice when you're doing it) you can heal, at least somewhat.

My last high-powered job required 12-hour days at the computer, and I was miserable with carpel tunnel pain in both hands. I wore wrist-braces faithfully and paid close attention to the ergonomics of computer use (there's a ton of information about this on the Internet), but I still had to give up my musical instruments and I couldn't sew or knit anymore either.

Got rid of the job, and I got rid of the pain (after a year or two). I still bring it on myself when I stop being vigilant about good posture at the computer, taking enforced 15 minute breaks from typing, cutting fabric, practicing an instrument, gardening, etc. and it can take a couple of months before the pains go away (shoulder, elbow, wrists, thumbs).

Just a thought--since your pains sound very familiar to me, I thought maybe some of the same solutions could help.

mscriver said...

I failed. This is not a post about my shoulder. It was meant to be a post about the attempt to describe pain and the difficulty in understanding it. Maybe part of the problem is the proliferation of support groups online where people rush to give advice.

Prairie Mary