Virginia Woolf said of pain, “English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache… The merest schoolgirl, when she falls in love, has Shakespeare and Keats to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.”
Growing up, I was often told of the mythical story of beloved Karna, the spiritual son of the Hindu sun-God Surya and princess Kunti. In the Mahabharata, it is said he offered his lap as a pillow to his guru, Parashurama, when an insect bit him causing him to bleed but he endured the severe pain silently and without moving an inch so as to not disturb his teacher. Karna’s ability to endure endless physical and emotional pain is salient throughout the epic and struck the young me as so very unfair.
What is pain?
Pain is unfair. They say that pain is a feeling-state. It can manifest physically and then emotionally or vice versa. Scientists have found that pain is basically a flow of sensory information from the site of injury to the brain via a “gate” in the spinal cord. This gate, controls how and how much we experience pain. More importantly, this spinal gate can be opened or closed by several factors. For example, if her grandson bumps himself while playing, my mother would put jaggery in his mouth and the crying would stop as he resumed playing. Another way to do this is to rub the spot that he has bumped himself at. The pleasurable sensory jaggery distraction temporarily blocks the pain signals before they reach the brain or the nerves that register rubbing override the nerves that register pain! Alternatively, this is what I call magic.
Stress makes everything worse
We know that stress has taken on endemic proportions from the statistics of what are called the modern “deaths of despair.” These include opioid overdose, alcohol-related liver cirrhosis and suicide. When more stressed, the pain is greater and dependence on substances to deaden the pain is also excessive. The irony is that the role of pain is to alert you to danger in order to survive it and therefore pain gates are wide open when you are stressed and less open when you are relaxed.
Where medicines fail and chocolates work
Having been a chronic sufferer of an old sports injury and resulting lower-back pain, I heard more often than not “what doesn’t kill you makes you stronger.” NOPE. When medical science has no solutions for your pain and all it offers is a “grin and bear it” approach. Naturally, you do a Cochrane review and scan every peer-reviewed article on chronic pain and what science has to offer other than deadening your senses.
Anandamide plays a role in the generation of motivation and pleasure. I like chocolate and anandamide is found in chocolate (just saying). So, while drinking cups of hot cocoa, I decided to start my journey to manage my own pain. I was armed with the knowledge that my brain actually DOES control the perception of my pain rather directly and can thereby be “trained” to turn off forms of pain that are “useless” (such as in my case). There were things that I actually could do, that would help but now I knew how and why (mechanisms of action). This is extremely important. I need to know the magician’s tricks in order to really enjoy magic.
Like me, if you suffer from chronic pain, you need to start worrying less about your future, India’s future, your future finances, your client’s/bosses’ well-being, the political future of the world, terrorism, world poverty and so on. The worry will worsen your pain which paradoxically will affect your productivity (you get less done).
Ask yourself what makes the pain less (other than medicines).
1. Do warm baths or does a cold compress work ?
2. Does it help to massage yourself with aromatic oils and nice-smelling baths?
3. Do walks in nature help ?
4. Is gardening and your hands full of earth healing for you?
5. Do you love and appreciate silence? Will noise-cancelling headphones reduce the pain?
6. How about a diet modification? Naturopathy greatly helped me
7. There is yoga and chiropracty, but make sure you go to someone sound
8. There is also touch – going to a spa or for a hair wash and cut with that added head massage.
9. Creative work helps me – do you have a hobby you can obsess over? Whether it’s a Pinterest board of visually appealing images or a pottery course, they all help
10. What about abstinence? A forced abstinence from screens and work (yes, work)
Apart from this, to make the life of those you love easier, it is essential to label the irritability arising from pain as such (“I am irritable because I am in pain” – rather than, “stop making that ruckus and irritating me”). It was highly inconvenient for me to take days off of work, so I took the rather radical decision of quitting as head of department after 11 years of working at the only place I ever worked at in my life. This was probably the best decision of my life (although it seemed devastating at the time).
This last year of lockdown saw a bit of a relapse in my pain, but I feel better equipped to moderate my reaction to it. My tolerance for pain was always high but now I find myself more accepting of it. This, in turn, magically makes it more tolerable and less painful. When in extreme pain, remind yourself that you have every reason to dislike pain and want it out of your life but once you know its inevitability, your suffering becomes slightly more optional.
The future and “far out” interventions
Dr Devjit Srivastava, who specializes in anaesthesia and pain medicine, famously diagnosed the case of a Scottish woman with a rare genetic mutation who was unable to experience fear, was completely insensitive to pain and whose wounds healed quicker than the average human. In her, they found a genetic condition that resulted in elevated anandamide levels.
Anandamide is a fatty acid neurotransmitter (a sort of messenger that takes information from one cell to another) and gets its name from the Sanskrit work “ananda”, which translates as “joy, bliss, delight.” With the discovery that there are genes that mediate the (non-)experience of pain, it’s implications for future interventions in chronic, intractable pain and quality of life are stupendous and “faah-out.” Until then, we stick to good ol’ fashioned magic.