"Summat Chronic!"


Remember the British expression for a fleeting affliction–“summat and nowt”? Well, if that affliction lingers, it turns into “summat chronic,” an idiom which has morphed into a set of verbal twins [one good, one evil]. Thus, I could tell Lili the dog, “Girl, I luv you summat chronic!”; or most of the patrons in the vast waiting room at work [which we share with neurologists and Pain Management specialists] could say to one another [especially, if they happen to be from the UK], “Oooh! Me (insert body part) has been playin’ me up summat chronic!”

Given the connection between pain and anger, when the waiting room gets crowded, you can feel the pent-up rage rising. How tempting, to try to replicate the Keele experiment: “On the count of 3, everybody, yell out the expletive of your choice! You’ll feel better!” [Not gonna happen. Wouldn’t provide a longterm solution, anyway.]

The problem with any remedy for pain [be it a barked obscenity or a wallaby-endorsed opiate] is that–to quote a U. of Michigan med school classmate of my husband’s, Herb Malinoff, now the Maven of Pain in Ann Arbor–“When you start taking pain medications, the brain doesn’t like it. The ability to perceive pain is extremely important for survival. Pain keeps you from danger.”

There is an old cultural joke, made famous by Peter Cook and Dudley Moore in Beyond the Fringe, in a skit involving one of them trying to communicate with a baffled foreigner. “It’s no use. He doesn’t understand. You’ll have to shout.” Well, that’s the brain’s motto, too. If we don’t acknowledge the “howling wolf” of pain, or if we try to quash it with a pain-killer, the “howling wolf” is going to “throw a strop” [British for pitch a fit], and turn up the volume. “Oy! I’m talkin’ to you! ‘Danger,’ you thick-o! ‘DANGER!'” And so, says Herb, the battle of wills, between the Pain Messenger in our brain and the Pain Manager in our healthcare plan, escalates. The result is often hyperalgesia [hypersensitivity to pain].

So, waddaya gonna do? I shall humbly suggest an approach, based on Victoria Stillwell’s dog training method. When the dog first barks, she says, we should thank it for doing its job. [No doubt, she grew up with the motto, “Why keep a dog and bark, yourself?”] Not that we should literally express gratitude for the pain, mind you, not rejoice in it; but instead of asking the rhetorical, Existential question, “Why me?” [“This is awful!”], try asking the more useful question, “Why now?” [“Cuz this is highly inconvenient. I have other plans.“] Remember my “Always? Not always” prof’s suggestion, to identify the person whose head you’d like to bash in, as a headache remedy? That’s a “Why now?” problem-solving line of inquiry. The cliche, textbook reason for why your hand hurts now, is that you’ve inadvertently laid it on a hot stove. Sometimes, however, the cause and effect are not so proximate. The reason your head hurts now may have to do with what you drank last night. Or that you need an updated correction for your specs. Or that the air in your city is becoming more toxic. The less proximate the cause of your pain, the more inexorable [and hopeless] it seems. [“Note to Self: ‘Become rich enough to move away from New Delhi.'”]

Consider another well-worn motto: “What can’t be cured must be endured.” The next post will deal with non-pharmaceutical methods of coping with pain. Until then, consider Lili’s remedy for emotional stress–her favorite squeaky toy, “Duck”–the foot of whom you see here. She has more than 10 other squeaky toys; but “Duck” is her “Teddy bear.” Whenever she senses bad vibes in the household, or simply wants us all to go to bed so she can quit guarding us, she parades around with “Duck” in her mouth. No doubt, you have a “Teddy bear,” too. When our younger daughter was to have her tonsils out, we were instructed in the pre-op briefing to have her bring her favorite plush animal [“Gus” the cat], who was solemnly given his own scrub cap and who was in her arms from check-in to recovery. Henry Ford Hospital knows a thing or two about helping kids cope with pain, by first helping them cope with fear.

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Filed under Epictetus said..., pain reduction, transitional objects

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