“There’s really not much we can do for you.”
The doctor’s words are still ringing in my ears as the metal slab slides me into the MRI machine. I’m wearing ill-fitting hospital pants that look and smell like they’ve been worn 500 times before. The technicians asked if I wanted to listen to music and I stupidly said yes. But the only thing I can hear in the headphones is an endless series of Christmas ads in Dutch. This won’t drown out the horrible clanging of the MRI, or in any way calm my adrenaline-fueled heart. As the machine tightens around me, I close my eyes in claustrophobic fear and grip the “panic” button. Without a doubt, I think, western medicine is utterly broken.
“Your pain? On a scale from one to ten?”
When he asks this, the doctor’s not making eye contact. He’s looking at his computer screen and ticking boxes.
I should tell him the pain today is a five or six, but that it’s been running higher the past few months on average, and that’s why I’m in his office. I know, based on experience, that if I tell him it’s a five or six today, the doctor will say: “That sounds manageable.”
And that’s true. I know I can go over the recommended dosage on my over-the-counter painkillers and get a small amount of temporary relief. They’ve been telling this since I first ruptured a disc in my lower back 25 years ago. Yeah, this isn’t my first Rodeo of Despair in the old L-4 L-5.
But it’s also false. The doctor doesn’t know that my pain scale ends at nine, not ten. You have to hedge your bets and imagine there’s something more excruciating than what you’ve experienced up to this point in your life, right? My pain level of six is, in reality, seven.
Also, you can’t take that quantity of painkillers longer-term without risking damage to your vital organs. How do I know that? The doctors have told me, usually about five minutes after advising me to be cavalier with the dosage.
I guess I take issue with how each of us understands the word “manageable.” Today? For one day? Yes, I can manage. But it’s hard to convey, in the course of a 15-minute consultation, the cumulative effects of more than two decades spent at a daily pain level of five or six.
Yes, western medicine is broken.
“There may be unforeseen costs.”
No shit, doc. There are the physical costs, sure. The days, sometimes stretching to weeks, when the pain edges up past eight. When you can’t find a position sitting, standing, or lying down that gives even the faintest hint of relief from the twisted muscles and pinched nerves.
There are also costs in terms of time and money. The endless hours of kneading, massaging, stretching, icing, heating. And screaming. Thousands of dollars worth of treatments: physical therapy, electrical muscle stimulation, lacrosse balls, balms, shiatsu massages, and, of course, painkillers.
The psychological costs? I think about the enjoyable activities I’ve been forced to give up: softball, golf, running, boxing, underwater basket-weaving. There’s also the overall effect of having my REM sleep interrupted, six nights out of seven, by pain. It’s hard to quantify the good moods turned bad, and the bad moods turned worse, by debilitating muscle spasms or shooting pains that run through my hip down to the tips of my toes. How many productive hours have I lost to pain-induced, focus-destroying fidgeting?
Western medicine may be broken. But my back is too. I get that.
“We don’t recommend surgery.”
I know this phrase in a variety of languages now. It turns out doctors don’t like poking around your spine with sharp objects. “Some people thrive after surgery,” they’ll tell you ruefully, “while others end up in wheelchairs for the rest of their lives.”
But they tend to deliver that non-recommendation before the results of the MRI are in. Even before they’ve done the most rudimentary physical exam. That exam, by the way, is usually a three-minute afterthought at the end of that long call and response session in front of a computer.
“Yes, it’s probably another herniated disc, but I guess we’ll do an MRI to be sure. Why didn’t you come to us sooner?”
“Because you always tell me there’s nothing…”
Broken. All of it.
“What are you doing to manage the pain?”
Here’s the truth: I don’t manage the pain. The pain manages me. It’s always there, telling me what I can and can’t do on any given day. And, over more than two decades, it has assuredly steered me—mentally, physically, and emotionally—in directions it wanted, rather than directions I wished to go.
The alien clangs and bleeps of the MRI machine. The barely audible Christmas ads in the headphones. The stale, constricted space incubating my waking fever-dreams of being buried alive. All reminders that there’s nothing much they can do.
Choose surgery or more physical therapy. Instead, continue a daily regimen that includes a mix of painkillers, alcohol, and magical thinking. Zap it with electricity, and/or sit in an ice bath (not at the same time, though). Find Jesus or a distracting hobby. It doesn’t matter. All relief, in the end, is temporary.
And what I keep saying about western medicine? It’s true.
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