Holds This

We have to feel a cer­tain amount of pain to change direc­tions, get help, stop injur­ing our­selves, etc. It turns out we, as a race, are obsti­nate. If it doesn’t hurt, we don’t stop doing what are doing even if it is destruc­tive. We per­sist in one direc­tion until pain nudges in a dif­fer­ent way – like a per­verse New­ton­ian law of motion. Maybe we are just lazy or maybe it’s a good plan. Why change what isn’t killing me? Of course, once it starts hurt­ing we might per­sist because chang­ing is incon­ve­nient, a has­sle, work. Again, back to us being lazy. Exam­ple: I have been in rela­tion­ships that I cer­tainly should have got­ten out of, but didn’t, even though the pain was there. I think of one in par­tic­u­lar in which my friends were beg­ging me to bail and I hung in there mis­er­able, until I had burned all options but to either lose a lot of peo­ple who loved me or run. I ran and the work of that was worth it. Although I am sure none of you have done any­thing like this, I had, in sev­eral areas of my life, per­fected this doomed strat­egy of denial, adopt­ing it my psyche’s pri­mary strat­egy. I do it less now and life is bet­ter, and it is as sim­ple as that. I stopped ignor­ing pain. Seems so sim­ple when I say it like that but it took half my life to learn it.

I got in to surgery because I got in to med­i­cine because I got inter­ested in psy­chi­a­try because I was study­ing psy­chol­ogy because I wanted to know why pain? When I got to med­ical school I found that every­one was won­der­ing about pain. In the med­ical world, sur­geons touch the pain, lit­er­ally. They put their fin­gers in the hole and stop the bleed­ing, find the pain and try to stop it. In the mean­time, between the find­ing and the stop­ping, they cause more pain. Is this mor­bid? yes. Are sur­geons aware of the psy­cho­log­i­cal ele­ments of trans­fer­ence and vul­ner­a­bil­ity that go along with the hands on craft? Rarely. But I will say this: we often (unknow­ingly for most of us) make up for it with rev­er­ence for the beauty we see inside you, and the priv­i­lege that you con­fer on us in let­ting us open you, look at you at your most naked, and touch you. We touch when you are utterly defense­less. It is so trust­ing, even ten­der, and when I think about it at all, it is one of the deep­est joys and high­est hon­ors of my life. Why do you let us (me!) in so close? Pain. You want to stop hurt­ing. Some­times I can help with that. Iron­i­cally, many peo­ple are fully will­ing let me to do all these inti­mate sur­gi­cal things to them but are com­pletely unwill­ingly to see a coun­selor about the deep­est hurts in their hearts that gnaw at them every day. Some pains are too much to move from.

The abdom­i­nal con­tents are held in a sac called the peri­toneum. It is a thin lay­ered cov­er­ing that is exquis­itely sen­si­tive to pain. If that con­tainer gets vio­lated, the per­son will­ingly heads for help. Peri­toni­tis is inflam­ma­tion of that sac. It is what makes appen­dici­tis hurt in the lower right abdomen. The peri­toneum is irri­tated. It’s the life saver, because it gen­er­ates enough pain to make us stop and change and get help. I am won­der­ing what today lines my heart that is so sen­si­tive that even the slight­est vio­la­tion will cause me to take action. What imme­di­ately comes to mind is my new, young fam­ily. We feel awk­ward, fal­ter­ing, even inno­cent. We are inter­de­pen­dent, inex­pe­ri­enced, vul­ner­a­ble. I am on alert to avoid pain as we make our way in the world, but I know the pain is inevitable. What doesn’t have to hap­pen is going through the pain alone. We can move to one another, help each other, get well. So I am learn­ing to let go of avoid­ing the pain. It will come when it comes. When it does I want to be a body in motion, mov­ing to you to help me, because it’s too much alone.