Pain is my constant companion. This has largely been the case for over a year, with all my emergency room visits, operations, and hospital stays. But since my abdominal perforation and the month-long hospitalization and three surgeries it entailed, pain has never left me. Pain that would have seemed unbearable two years ago now often seems merely a baseline level—unpleasant, uncomfortable, but not requiring any extraordinary measures. Only what my oncologist calls breakthrough pain is worth special notice.
Each time I’ve had some episode of overwhelming pain for hours and hours at a time, I’ve writhed around thinking or crying out “I can’t stand it, I can’t take it anymore.”? And each time I’ve discovered that I can indeed bear it, that I can take it. This isn’t a discovery I would have liked to make. All my illnesses, along with the various other crises in my life, have made me realize that I’m a much stronger person than thought I was, physically and psychically. But I would have been happy never to have known how strong I could be, never to have been put to that test, even though it’s a test I’ve passed over and over. One gets no prizes for passing it, though I suppose that having survived this most recent incident when many people wouldn’t have is a reward in itself.

Every room in the hospital had a little chart pinned to the wall with which one could measure one’s pain in a range from one (no pain) to ten (excruciating pain), accompanied by a series of round faces that went from a rather overly-perky smiley-face to what was supposed to be a picture of great, if cartoonish, suffering. “Are You in Pain?” the poster asked. Or as I always read it, “Are You Into Pain?” In Spanish, it would ask, “Tiene dolor?” Have you sorrow, have you grief? Why yes, I always thought, I do.
The nurses and other medical personnel would periodically ask what my pain level was, using the numbers on the chart. I tended to exaggerate, naming a slightly higher number than I felt, knowing that if I described my pain in the terms of someone who had become as acclimated to it as I had, they would dismiss it, not take it seriously. I tend to be fairly stoic about physical discomfort, and what would seem excruciating for most people is rarely so for me, not now anyway. Nonetheless, my felt pain level would rarely be lower than halfway through the chart—if it got down to four, that was a very good day indeed.
Concomitant with my ability to bear a great deal of pain is a persistent resistance to pain relievers, with which I’ve been afflicted since I was a child. When I would go to the dentist for the very extensive work I had back then, I had to be so pumped full of novocaine that I’d be numb for the whole day and sometimes into the next. (I began getting symptoms of Bell’s palsy facial paralysis in 1996 on a day when I’d been to the dentist, and at first I thought that the limpness on one side of my face was a lingering effect of the novocaine, until I realized that I couldn’t blink either.) Pills in particular do very little for me. Under its various names, Vicodin, Lortab, etc., is about as effective as sucking on a Ricola lozenge, except that it doesn’t taste very good. And so on up the line, Percocet, Demerol (more effective than most), etc. Even Dilaudid pills, which are supposed to be very potent, do very little to alleviate my pain.
I don’t drink, I don’t smoke, and I don’t take drugs, nor have I ever, but during my recent lengthy hospital sojourn I began to understand something of what an IV drug addict must feel when he or she shoots up and the drug hits her or his system. While oral Dilaudid is almost ineffective for me, intravenous Dilaudid relieves my pain quite quickly, though the effect is rather short-lived. I well remember many occasions lying in my bed in great pain waiting for the nurse to bring my pain medicine (everything in hospitals happens in slow motion, except when they decide that they’re going to take you down for a CT scan now), sometimes twitching and crying out.
If the nurse gives a Dilaudid shot too quickly, pushing it in all at once, it causes dizziness and nausea, but if she gives it slowly and properly diluted with saline solution, after a moment it produces a wave of calm and well-being that washes away the pain as it flows over one’s body. The feeling is fairly fleeting, but it’s a wonderful release after one has been crushed in pain’s grip. I imagine it’s the closest thing I’ll ever know to that “rush” or “high” that IV drug addicts experience, and it makes me understand a little why they are so desperate for it. That “Aah” of release and relief is my only fond memory of being in the hospital.
So no, I do not have pain. But pain has me, and will not let me go.

Originally Published: May 25th, 2008

Poet and editor Reginald Shepherd was born in New York City in 1963 and grew up in the Bronx. He earned a BA from Bennington College and studied at Brown University and the Iowa Writers’ Workshop. His first collection, Some Are Drowning (1994), won the Associated Writing Program’s Award in...

  1. May 26, 2008
     Brian Salchert

    Mr. Reginald Shepherd,
    May you and yours be blessed with
    all the strength you need and more.

  2. May 26, 2008
     Mary Meriam

    To write such a lucid, vivid, engaging essay, after having your guts ripped out, knocking on death's door, and being in excrutiating pain, is more evidence of your tremendous strength, Reginald. What is this strength? At the risk of sounding soppy, I'd say it's love that kept you alive. When you have love, you can make it through just about anything. You've got it in spades. I can see why you inspired such devotion in Robert. Now that you've almost died, I think that even better poems are ahead of you.

  3. May 27, 2008

    I'm sorry to hear about your travails.
    Are you seeing a pain specialist? Studies have shown that racial minorities and women are under-treated for pain, so don't let the medical personnel dismiss your level of pain even though you have a high-tolerance. Chronic pain re-wires your brain. :(
    There are other things you can try along with medication, that a good pain intervention center can let you know about. (Like cranking up a TENS unit too high, so you get an flood of endorphins for a few hours.)

  4. May 27, 2008
     Emily Warn

    I've always thought that those numerical pain-ranges were whacky. How do you quantify pain? And, as is evident in your post, they seem inherently psychological. Is there a limit to excruciating pain? How does 10 register in a stoic personality vs. a fearful personality? Etcetera.
    And, I certainly hope that, as Jilly suggests, some pain specialist can keep you between the 1-4 range.

  5. May 27, 2008

    Dear Mr. Shepherd,
    Reading your post reminds me of the frustration I have felt at being in pain (though not as great as yours) and being under a doctor's care. I say frustration, and I mean just that--your pronouncement, "Pain has me," is an accurate, no, I guess I mean elegant, description of the powerlessness and impotence prolonged illness can affect. I, at least, felt angry that I could not fix it, that no one could fix it, that no one around me seemed to be outraged at or fully aware of what I was going through, (which I know sounds selfish, but when it hurts, it's hard for anything else to be at the center of your awareness but your very present body). Pain is just not very speakable, I guess. There's no expressing it, fully. And as you've noted, there's no way, many times, of circumnavigating it. Just, you know, you go straight through it. It's so solitary. I'm sorry it has you. I'm sorry it's so solitary. I hope it eases. Thanks for sharing this with us.