Sunday, February 8, 2009

The Arrival of Pain

More mysteries of the mind and body. Here’s what a good friend who’s been around a lot said in an e-mail just this morning, commenting on challenges of his own:
“My stuff is so minor in comparison to what Brooke (and you) are faced with, I question ever letting it come up. I guess friends care for each other's problems no matter their size. This week I have felt very knocked about by the reality of a spine injury and the long hard road to whatever recovery is reached. My God that man's an athlete. And to realize that it's his mind that drags his body to the summit of peak after peak, muscle twitch by muscle twitch leaves me stunned in admiration. The arduousness of the path has been heavily impressed upon me this week. This ain't easy.”

That was before what happened today. Only hours later, Brooke had his first episode of pain, as distinct from discomfort--severe, whole-body pain. The nurse asked him to rank it on a scale of 1-10; he ranked it a 12. But what’s remarkable is that, except for pain in his neck, this is the first episode of bodily pain since the accident. He’s had endless amounts of what you’d trivialize by calling it discomfort (“noxious stimuli” said one clinician), but says he has never experienced actual pain—and then wham!

He said he tried to think about worse pain—Confederate soldiers lying on the field of battle. And then he tried to deal with it by making himself smile, and after he could speak tell jokes about the pain. And by this evening, he’s “resting comfortably” as they say in hospital-speak, talking with the friend who wrote the lines above, about Ornette Coleman, Count Basie, Joe Turner, and a Hammond B-3 organ. And smiling.

Question is, what is this pain? Could it conceivably be yet another set of circuits reconnecting? The effort is to try to think of it as, uh, progress, sort of along the lines of “no pain, no gain.” At least for this amount of pain you can get TWO Lortab. Imagine.


ffisher612 said...

Jesus, Brooke. I don't know whether to laugh or cry. When I was bending your knuckles the other day I felt stupid asking you to tell me when it hurt because I realized it didn't and wouldn't. I'm elated to think that next time it might, but please God not too much. 12 on a scale of 10 is hideous. I'm white-knuckled hoping it signals some reconnection. See you again soon.

Gavin Noyes said...

I can't imagine what that kind of pain must be like. My heart goes out to you.
I'll also recommend a great book which explores that question of "what is pain?" Understanding pain better, and doing something about it however, are two very different things. Anyway, a neurobiologist friend recommended this book called "Phantoms of the Brain" by VS Ramachandran.
Ramachandran is doctor who treats pain in phantom limbs by visually tricking the mind (with mirrors) into thinking it is doing something it is not, like opening a tightly clenched phantom fist. When patients see their phantom fist open, the pain stops.
He also explains where neurons in the brain connect and where they are likely to realign themselves when nerve endings are severed. For example, neurons from a lost hand are likely to reconnect to the face (because they are connected next to each other in the brain.) So stimulus to the face can cause pain in the missing hand. It is an interesting read and not at all woo-ey.