At the Will of the Body: Part I (Pain)

Lisa Freitag says:

Dr. Lisa Freitag is a former pediatrician in Minneapolis, Minnesota. She wrote some guest posts for us in 2013, and we are delighted to have more of her insightful presence here. This is the first of three or four parts; watch for the others over the next month or so, between posts from Laurie and Debbie. 

It is not clear to me whether it is a side effect of having gone to medical school or an inborn personality trait, but I have always had a rather distant relationship with my body. This, I believe, is not completely uncommon. David Sedaris, in an essay called “A Shiner Like A Diamond” (in Me Talk Pretty One Day) says that he and his brother thought of their bodies as “mere vehicles . . . machines designed to transport our thoughts from one place to another.” (p. 133) His sisters, by contrast, were not allowed to ignore their bodies; they were expected to maintain and decorate them, presumably in order to attract a mate. It seems to me that this could be considered as merely a different form of distancing body and self. But, either way, I gave up early on the feminine decorating bit, and completely subscribed to the idea of the body as a convenient form of transportation.

I just expected my body to walking across a parking lot, straight into a negative 20-plus wind chill. There was a layer of ice at least an inch thick over everything, but it was way too cold to be slippery. All I wanted was to reach a restaurant where it would be warm. Then suddenly my feet swept sideways, and in an instinctive action that I had no time to consider, my entire body weight landed on my left elbow and shoulder. There was pain. No further description is adequate. I waited for it to subside, like it usually does after your mind takes back control, but it did not. With no other choice, really, I got to my feet and walked the rest of the way into Noodles and Company where I sat down at the nearest table. Collapsed actually might be a better word. My body would no longer obey my will.

I stole the title for this essay from a 1991 book by Arthur Frank, a “medical anthropologist” who is quite famous in ethics circles for his writing on the nature of illness and the doctor-patient relationship. He wrote At the Will of the Body after a heart attack at age 41 and a diagnosis of testicular cancer the following year. He is still alive and lecturing about this at ethics conferences, so there is no suspense involved. The book is not about learning to die, but about learning to live in a body that is not performing as expected.

Before the heart attack, Frank was a physically fit man, who was able to run marathons. He unfortunately doesn’t describe what it was like for him to live in this body, as if he never noticed it at all, except to keep it tuned and running like a good car. After the heart attack, he could not depend on his body to help him keep up his image as an athlete, but he was still functional. The cancer put an end to that also, for a while.

And the cancer was heralded by pain, which became the subject of one of the first chapters of the book.

He noticed, as I have, that it is impossible to describe pain. You can point to locations and play with pain scales, but nothing approaches a coherent description of the experience of being in pain. I have found that the more someone complains, the more exaggerated the words chosen to express pain, the less likely one is to be believed. Fewer words have almost exactly the same effect, since pain endured stoically becomes pain ignored by others. Frank believes this is a form of silencing. “Unable to express pain,” he says, “we come to believe there is nothing to say. Silenced, we become isolated in pain, and the isolation increases the pain.” (p. 30)

Pain, Frank thinks, takes over everything else, isolating us inside our bodies and setting us apart from others. The mythology of pain makes it into an external enemy which must be fought, but pain is not a thing separate from the self. Frank feels that his pain, which was a warning signal that something was wrong, made him more aware of his body. The pain was not an external enemy, but a fact of his embodied existence. He says, “Dealing with pain is not war with something outside the body; it is the body coming back to itself.” (p. 32) Pain comes from the body, and so facing pain is facing oneself.

This was not exactly my experience. There was a long, horrible time during which I still imagined things getting quickly back to normal. Since I could not move my arm, and even a tiny bit of movement of my shoulder caused impossible pain, I thought my shoulder might be dislocated. I had a vague idea that if it could be quickly relocated, I could still go on to have dinner and go home. But my body would not cooperate, absolutely refused to walk back to my car and drive me home. There was instead a stretcher, an ambulance, an IV, and narcotics, which I declined but was given anyway. When your body no longer obeys your will, I guess no one else has to either.

I did not have a dislocated shoulder. A series of x-rays, during which my language was quite atrocious, showed a very obvious separation of my elbow, and some mild shoulder displacement due to a displaced fracture. And so, instead of going home and doing whatever it was that I’d meant to do with the next few weeks, I became acquainted with pain.

Perhaps I came back to my self as a body, as Frank did, but that awareness did not seem at all desirable. There was certainly loneliness and isolation, with no way out. I was trapped in my body. Oddly, the elbow, which was the most serious fracture, did not hurt at all (then, anyway). But my shoulder was a weight both holding me down physically and keeping my mental focus internal. Nothing else existed.

I had to stay in the hospital that first night, because I couldn’t move, nailed to the bed by pain that became more intolerable at the slightest shift of position. I was sent home the next morning in a splint that felt like it weighed twenty pounds, to a new world that held very little other than pain. Then they had me come back a week later to have surgery on both joints, and the pain began all over again. After surgery, I needed two nights in the hospital before I could make my body do anything. My shoulder hurt too much.

Eventually Frank was able to do something that he called “seeing through” his pain. He was able to accept the pain and the fragility of his own body, by appreciating that there was still beauty in the world. He found this a transcendent experience, and wrote a five-line “haiku” about it.

I had no transcendent experiences involving pain. It did indeed isolate me in my body and then pin my body to the earth. I did not appreciate any extra awareness that this might have provided. No bad haiku for me.

The pain that Frank was able to “see through” was very different from mine, of course, and ultimately of vastly more importance and consequence for his life. He was, at the point he wrote about it, having pain mostly at night, and was often awake and wandering his house alone. He did not yet know that cancer was causing the pain, and part of his experience was the anxiety of uncertainty. What he saw, through this pain, was a beauty in living that he hadn’t understood until grounded in his own body by the possibility of illness. The pain became more tolerable because of its inability to prevent this joy. I think what he learned was that, while the pain was HIS whole world, the pain was not THE whole world.

For me, the pain was instantly identifiable and expected to improve with healing and, indeed, it did. I’m a bit disappointed that I was unable to see anything “through” it at any point. It feels like some sort of moral failure. Perhaps as a woman I already know vulnerability in a way that Frank could not. Perhaps with the pain slowly improving, I got used to it, and became able to ignore it rather than needing to “see through” it. Perhaps I’ve already learned to see the beauty in the world in other ways.

More likely, I’m just not as nice a person as Frank, unable to find beauty in adversity and instead resenting it very much. In a later chapter, Frank watches from his window as people run past the hospital where he is receiving chemotherapy. He takes joy in the unrestrained movement of their bodies. I’m afraid that I watch people with two functional arms and feel mostly an extreme jealousy.

At this point, my worst pain is pain I cause myself by doing the recommended physical therapy, something I understand I must do if I am going to regain full use of my left arm. My body will once again transport me from place to place, but it is having trouble carrying things.

The shoulder hurts, though not at much, but the elbow won’t bend past ninety degrees. This is astonishingly inconvenient. I spend hours a day doing exercises, during which there is no question that it is not “the” shoulder and elbow, but “my” shoulder and elbow that are hurting. I am exerting my will over my body by causing myself pain.

I fear I want my body to obey me again, and as soon as possible, so I can get on with ignoring it as usual.

3 thoughts on “At the Will of the Body: Part I (Pain)

  1. Wow! That’s really interesting. It makes me glad I have a high pain threshold and most of my major pain experiences have been accompanied by shock.

    On the other hand, in spite of living in my head a lot, I have been athletic in my youth, studied dance for 7 years, and developed a sense of living in my body and expressing myself as a actor (if only minorly as an amateur) via physicality. This, probably plus my high threshold, have given me a different relationship with pain. On the one hand, from my most painful experience I have no memory of how the pain was. On the other hand, I was “in the world” the whole time.

    Maybe being physical, being used to living in one’s body and being hurt in minor ways–the usual concommittent of being physical–makes it easier to stay “in the world” when the pain is major. It isn’t strange, it isn’t a surprise, the physical channels have been used and one knows how they work.

    1. Suford, I think this is dead on target–people used to living solely in their (our) heads are more startled by being forced into our bodies by pain, while people with more ongoing body awareness, whether it is through pain or through body usage. Thanks for the insight (and sorry it took us so long to respond to your comment).

  2. As someone who also lives in her body, I agree with Deb, that you’re quite right. Also apologies for delay, I’ve been working on very tight deadlines with my head down.

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