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Pain, Abjection, and False Idols

I was crying on the phone today with a nurse from my doctor’s office, a suppliant asking for pain relief for the 16 hours between the time of our call and my root canal, scheduled for tomorrow morning at 7:45 am. And the nurse just had to bring up natural childbirth.

“It’s better not to take pain medication before surgery, because you build up a tolerance, and then you need even more pain meds after the surgery,” she said.

“It’s not surgery!” I protested. “Everyone says the pain will get better as soon as the procedure is finished.”

“Well, pain is different for everyone,” she chided. “Look at me, I had two births with no pain relief, but my sister, she had to have an epidural and all that stuff. People are different.”

I didn’t bother telling her that I also had two births with no pain relief, because that would undoubtedly have taken us into a comparative analysis of pain. “Surely this isn’t worse than childbirth, is it?” she might have asked me sweetly.


Several years ago, I told one of my best friends, one of my natural parenting friends whom I met in my earliest months as a mother, that if I should have a third baby, I would get the damn epidural. She was shocked and tried to persuade me to reconsider what I would do about the hypothetical third birth that in fact never happened, reminding me about the dangers for mothers and children of highly medicalized births. And if I had actually gotten pregnant again, I would have done a lot of research and thinking and maybe changed my mind, but since I didn’t, I could just go with my gut when I told her, “I think I already learned as much as I can learn from pain from going through that twice. I don’t think there is more to learn about that, and if there is, I’m not interested.” I had decided that I was willing to weigh the possibility of slightly worse outcomes against the certainty of more pain than I want to go through a third time and to choose the slightly worse outcomes.

What had changed for me? Well, when I had those two unmedicated births, I was a sincere, nearly ardent Catholic, and Catholicism has a millennia-old tradition of prizing suffering. I wasn’t so fundamentalist as to think that suffering in childbirth was my necessary punishment for Eve’s sin; rather, in a tradition that valorizes suffering—especially unnecessary suffering that one chooses for oneself (hairshirts, flagella, stigmata, and more for the celebrated saints; Lenten mortifications of the flesh for believers today)—it just made sense for me to embrace that pain.

And I did learn things, not so much the second time as the first. I remember the fear of splitting apart, of breaking entirely and unfixably. It was because of my fear that I ended up pushing for three hours with that birth—I was afraid, and so I was holding back. There came a moment when I realized—like really realized, not intellectually and logically, but fully and in every way—that there was no going backward, that the only way to get to the other side of this terrifying event that was happening to me and in me, that was happening in every way except *by* me, was through it. No backing up, no going around it, only straight through. He was born shortly after that moment. I did not break. I still think of that moment sometimes when I have to complete something difficult or unpleasant. So yes, I learned something—achievement unlocked.


I no longer believe that choosing avoidable suffering is in any way a spiritually meritorious act, and I have spent the years since I left the Catholic Church distrustful of anything that smacks of asceticism, but I have recently come to believe that there could be a spiritual dimension to enduring unavoidable suffering with patience.

I had some calcifications in my breast biopsied earlier this month (I know, right? What a great month I’m having! At least the biopsy results were negative). The process to get me into the biopsy contraption was itself quite uncomfortable. I lay there a while, facing away from the door, trying not to move, with my right breast . . . well, I don’t know if it was visible from the door, but that’s the first thing I thought of when I heard the door open and the male doctor’s voice speaking to me. I wondered if the female mammogram technician would return to the room for the biopsy. Of course that’s usually what happens, but my mind wandered onto the thought experiment of what I would do if the man walked into the room and, say, tweaked my nipple. Here I was, lying on a table with a hole in it, my breast hanging down through it and squeezed between small mammo plates: cowlike, compressed, potentially malignant, and yet always and inevitably coded as sexual in our culture. What would I do? It was an easy decision: nothing at all, because to do anything, even to yell, would risk me shifting my position, which would mean starting the whole process of getting me positioned again. This is the abjection of being a medicalized body.

There was also the part where I told the doctor that it usually takes extra shots to numb me for local anesthetic, and that therefore he should inject me with extra lidocaine (a 100% nonaddictive local anesthetic) instead of waiting and seeing. He didn’t. He waited until I cried out when the pain from the first sample fanned out and intensified just as the needle was grabbing the second sample.

“What’s wrong?” he barked.

“It hurts!” I moaned.

“Well, you have to tell me that.”

So then I had another ten minutes holding still in the uncomfortable contraption while we waited for the second dose of lidocaine to take effect. This is the abjection of “the doctor knows your body better than you do.”

And yet there was one valuable part of the experience: I stayed present. Twenty-five years ago, when I had my wisdom teeth removed under local anesthetic, I worked to separate my mind from my body as much as I could. I went somewhere in my mind and tried to remember details from the plots of movies I liked. I kept my mind busy; my body was on its own. Both because I now know that the body knows what happens to it even if the mind goes away, and because I have recently been working to strengthen my practice of meditation, I wanted to stay present. More specifically, I wanted to try to be emotionally temperate: neither ignoring nor minimizing nor amplifying what I was feeling. “Biopsy is just biopsy,” I said to myself, based on a bit of wisdom I read a decade ago by an Indianapolis Zen teacher. And also: “This sucks,” I said to myself. “Yep, it sure does. Here we are.”


So there might be something valuable in being able to patiently endure unavoidable pain, but I reject the idea that there is spiritual merit in seeking out avoidable pain. It might be possible to endure avoidable pain as a form of practice, to prepare oneself for patience in facing unavoidable pain, but still, I think the human tendency is to move pretty quickly to ideas of merit and to patting oneself on the back.

But with the opioid epidemic, the medical establishment has turned what used to be avoidable pain into pain that is, practically speaking, unavoidable, and with that conversation with the nurse today, I could see how an individual medical worker’s spiritual ideas about pain and suffering can intersect with the new practices in pain management. I don’t believe that the nurse believes that she and her sister simply have different tolerances for pain. I believe that she believes that she has merit for having given birth twice without medication, because otherwise, why on earth would she bring it up with me? The upshot of my two calls to my doctor’s office today is that the office won’t call in a prescription to cover 16 hours of pain relief, but they recommend that if the pain gets really bad or the swelling gets worse, I should go to the ER. This is the abjection of “we have to treat you like an addict, because you might be an addict.”

–In solidarity with the citizens of the Land of Pain and Abjection from a visitor who will almost certainly live there someday, because I’m so sorry you have to put up with this shit every day.



4 Replies to “Pain, Abjection, and False Idols”

  1. As ever, I’m glad to get to read your work. And, because I work in a substance abuse clinic, I find myself focusing on your note that “with the opioid epidemic, the medical establishment has turned what used to be avoidable pain into pain that is, practically speaking, unavoidable.” Some of the issue is self-protection; several states are enacting laws to punish physicians whose patients become addicted, and, in other places, social pressures mount. It is also the case that people *do* become addicted to various pain medications, and in short order; I certainly see enough of them in my daily work to attest to it. So the issue becomes, at least in some cases, one of weighing present pain versus future pain; I believe you that it hurts, and immensely, but I also see the pain that others go through trying to wean themselves off of addictions they did not know they had until they had it, and I have to think that, in many cases, the latter is worse (in itself, and leaving aside the legal and social ramifications).

    I’m not sure there is an easy answer to the issue. But I hope your root canal goes well and swiftly, and I look forward to seeing you again.


    1. I will see you in Kalamazoo this May, yes? Thanks so much for your perspective, Geoffrey. You have a lot more experience with addiction — I tell people that the reason I value having read Infinite Jest so much is that I never understood or could imagine the experience of addiction even a little bit before reading that book, because I am fortunate to be pretty resistant to addiction. That novel really opened my eyes to the suffering of addiction.


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