Inspired by reading “The Invisible Kingdom: Reimagining Chronic Illness,” by Meghan O’Rourke
The physician’s assistant asked, “On a scale of one to ten, how bad is the pain?”
I responded, “Four… maybe?
Pain is a solitary experience, something no one else shares, it is always hard to describe. For me it is more like a noise getting louder or softer. It comes and goes and when it goes, it mostly disappears from my memory. Words never quite convey the feeling… the ache, the sharp stab, the feeling that something inside is pulling tissue deep inside my gut.
Not only that, how could I possibly categorize this pain on a scale with one I have had before… like the times I have sprained an ankle, or the time I could barely breathe after the car accident when the airbag cracked my sternum. I’m glad I cannot bring those sensations back clearly to my mind. I remember them only as events that I want to forget.
On a scale of one to ten, how bad is the pain? This question does not ask me to describe the complexity or the variability of what I feel. It is not one sensation, nor is it the same from minute to minute. In frustration, I mutter, “I hate this question.”
Still I want others to understand that I am in pain. It takes energy to hide or pretend. When I try to communicate with friends, it stirs something in them. Many feel some responsibility to respond. Some encourage me to think more positively. One offers a suggestion, intended to be helpful. “Try writing from your non-dominant hand and see what you learn about the source of your pain.”
“I haven’t been able to write easily even with my dominant hand since a hemorrhagic stroke left some Wernicke’s aphasia two dozen years ago,” I mutter. Frustrated, I struggle to show appreciation for all suggestions, but I can’t always summon genuine gratitude.
There may be nothing someone else could say that would truly help, though people try. Those who are uncomfortable with illness or disability often respond with sympathy, or worse, praise for my endurance. I feel the gap between us widen, a chasm between us that words cannot bridge.
When my primary care doctor enters the examining room. I say, “I imagine that this pain might be caused by adhesions from the liver transplant I had nine years ago. It has been sporadic now for a few years, usually lasting a few days or more, then disappearing. This time it is not going away,”
She believes me and I am grateful. There have been lots of times when doctors have not believed my uncharacteristic symptoms.
She orders an X-ray of my lungs and ribs. The pain seems to be radiating from my lowest rib and it doesn’t increase or decrease when she presses on my side and abdomen. She also orders a short term dose of Prednisone.
I know that all medications, even those that help, come with consequences. Today the pain is gone. Even the chronic ache in my shoulders has quieted for now. I’ve been more restless. I crave sweets.
Yesterday I took the last dose. The pain is gone. Even the chronic ache in my shoulders has quieted. The side effects are diminishing. And now that the medication is finished, I can admit what I couldn’t before. I am tired of pretending I’m fine; tired of reassuring my loved ones, my friends… and myself. Because what cannot be seen is still there, waiting, whether anyone else knows how to measure it or not.





