Thursday, February 6, 2014

How pain changes us

When I was eleven years old, my family adopted a dog from the San Francisco animal shelter. She was a special dog-- a regal mutt with the posture and coat of a Doberman, softened by an unidentifiable 'other'. We didn't meet her at the shelter. In fact, my mom found her one early morning stepping off the commuter bus in San Francisco. The dog was running up and down Parnassus Avenue with no supervision-- a recipe for disaster. Mom coaxed her into her capture and kept her on campus for several hours until animal control was able to retrieve her. When the dog-catcher finally picked her up, he mentioned casually to my mother that she had first rights if no one claimed her.

A week later, we took her home.

We named her Skippy, after our favorite peanut butter.  Skippy spent the entire 40 minute drive home jubilantly licking my little sister's face in the back seat.  She was elated!

Two weeks later, Skippy broke her leg running in the hills by our house, and over the next several days she morphed from a vivacious lovable licker into a seriously mixed blessing. She became cranky and frustrated. She was easily upset and downright mean. Perhaps worst of all, she was unpredictable.

We often have wondered how much that broken leg shaped Skippy's personality and her world-view-- after all, the story only begins with the broken leg. The aftermath was months and months of casts, pain, repeated trips to the vet, restricted mobility, and a serious lack of exercise. During her darkest moments, Skippy would literally lay down in the middle of the road and refuse to walk a single step further. If we tried to coax her, she would bare her teeth and growl. There were multiple instances when 12-year-old me would sit in the middle of the street for thirty minutes or more waiting for her to be ready to move on. She also began to snap at us if we tried to keep her from chewing at her cast and soon became tremendously possessive about her food.

She was angry.  We were scared.

Eventually Skippy recovered physically, and though she did not seem to suffer permanent disability from her broken leg, the effects of those few months on her personality never retreated completely. For much of the next twelve years, she was a loyal, playful and loving dog, but she was forever unpredictable. When upset or unhappy, she would bare her teeth and growl. She bit all of us at one time or another (plus my favorite cousin, at least one neighbor, a passing cyclist, and the mailman). She misbehaved frequently and did not respond well to correction. She often acted wounded, not in a pathetic beaten-down sort of way, but in a overcompensating self-righteous way. She remained a behavioral challenge her whole life, and we adjusted many of our own family patterns around her capriciousness. And yet, we loved her.

We loved Skippy so much-- so much so, in fact, that almost ten years after her death, we still reminisce regularly about how smart she was and how special she was, despite her very obvious shortcomings

Even so, I will always wonder what pain did to her psyche.

As a physician, I see lot of pain during my work days: headaches, ear pain, neck spasms, low back pain, chest pressure, stomach pain, pelvic pain, hip pain, knee pain, finger pain, and even isolated large toe pain (gosh darn gout!). Heck, much of my day is filled attending to patients in pain.

And this little list doesn't include all the examples of what I like to refer to as life pain: pain caused by separation and divorce, abandonment, addiction, poverty, unstable housing, violence, depression, poor self esteem, physical disability, learning challenges, generational oppression, sexual assault, sexism, racism, and more.

The list of things that cause pain is endless. And pain changes us, just like it changed Skippy.

Pain makes some of us edgy and anxious. It makes others impatient and frustrated. And still others tired and listless. It colors the world in a yucky grey-brown color that kind of looks like a mix of vomit and poop and makes us not want to eat, ever again. It shortens our fuses, lengthens our nights. It turns some from half-full leaders into half-empty followers. It disrupts sleep and one's sense of smell. It influences appetite, making some eat more, others less. It's depressing and anxiety-producing. It's scary.

Those of us who have been lucky to live much of our lives without pain should consider how crappy we feel when our throat hurts for a day or our wrist aches after writing a long letter. Many of us crumble completely under just a few hours of discomfort. Others tolerate quite a bit, until we can tolerate not one moment more. Pain is life altering in ways that we might never predict, until we experience it.

Like Skippy, I believe we are all lovable lickers in our essence. Most of us want nothing more than to gallop through the hills at full speed, be caressed by those who love us, get scratched in that spot that itches the most, be commended for our beauty, and be given special treats for good deeds. But, just like Skippy, we are also all mixed-blessings, victims of our life circumstances and undeniably changed by the myriad pains that we experience. After all, we cannot completely avoid pain.

And so, this is what I wish for all of us:

May  our pain be limited.
May our pain be tolerable.
May we acknowledge the power of pain over our very essence.
May we believe in the power of recovery.
May we be patient.
And may we not bite one another at any point in the process.


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