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.