Pain and Memory

I love patients who offer a good challenge, but D was a tough one, even for me. In his forties, he had broken over 80 bones, was involved in several major car accidents, and had a myriad of unrelated health problems to boot. When I first met him three months ago, he hobbled into the clinic and could barely sit still because of his discomfort. His main complaint that day was his left hip, leg, and back. Not surprising, since he had completely shattered that leg several years prior. I liked D. He was very honest about his unconventional lifestyle, and he managed to maintain a sense of humor despite the pain. We talked about his pain a lot-he is not a very articulate man, and he seemed to crave a way to define himself outside of the pain through discussion about it. Yet he was unable to do so. He saw this pain as such a part of him that his entire personality and worldview was shaped by it. He felt that he could not live as an authentic version of himself anymore, because the pain drained away at his very nature.

Since I was treating him in a community acupuncture setting, all of the needles were below his knees and elbows. He was surprised that I wasn't inserting any needles into his back, where the main problem was, but I assured him that the treatment would work, and it did. Fast forward to three months later. This blog post is not about an acupuncture success story, so suffice it to say that his improvement was remarkable, in all areas of his life. Usually he came to treatment with a huge smile on his face, but this day he seemed grim. I asked him what was wrong. At first he seemed reluctant to tell me, but then he finally explained what was bothering him.

"When I started coming here I was in so much pain, and I used to dream about what it would be like to get out of bed and be able to just do it with no problem. What it would be like to put my feet right down on the floor and not have to work into it. And today, I realized I've been putting my feet right down every morning without pain, and I can't even appreciate it because I don't remember the pain anymore! It sucks!"

Well. I was flummoxed. This was the first time that I'd had a patient complain because the pain had gone away! I explained that the mind is not designed to hold on to the memory of pain, and that once pain is over it is very difficult to recall just how it felt. Which was a good thing, I assured him; if the memory of pain lingered on and on, no one would ever have a second child! He laughed at that, but he still seemed disturbed. He seemed to really need some sort of sharp contrast between the life he had been living, and his current pain-free life.

I had always wondered about the dilemma of chronic pain-sufferers who define their world through pain, and what would happen to their self-image if that pain was to suddenly disappear. Now I knew. So much food for thought.