Where Does It Hurt?

On Thursday, I shut my hand in the car door. The latch clicked home and the door was fully seated in its frame when it hit me–not pain, but the cold realization that intense pain was imminent and inevitable.

This moment has always fascinated me (and I’ve had more than one occasion to experience it myself): How can something so instantaneous as pain have a time delay just when it should be at its worst? Papercuts, bashed knuckles, stubbed toes–these insults don’t wait to howl their pain signals down your every nerve pathway. That pain lights up the brain before it even knows exactly what’s happened to cause it.

But this pain, this pain is patient. It waits for the mind to do its thousand-thoughts-at-once thing before it settles in to throb throb throb away. When the door closed, I didn’t gasp or curse or yell. In that instant, the implications of the decisive *click* of the latch while my fingers were where they shouldn’t have been crystallized in vivid, absurd detail. I thought of cartoon fingers steam-rollered flat, and almost laughed.

With my digits mashed between two unforgiving sheets of molded metal, I almost laughed.

While nursing my wounds later in the day, I pulled out my copy of Pain: The Fifth Vital Sign. This one’s due for a re-read, and now it was apropos. Jackson points out early in the book that pain is, above all, an emotional response. We can’t isolate the science of pain, the hard, rational facts of neurochemistry and biology, from the purely subjective, ever-changing, emotional response of the pained. Pain may tap into great, deep wells of fear or anxiety or anger, and it may give no warning or make any sense at all that it does.

The pain of shutting my hand in the car door touched ever so briefly into my own fears of disability–as I thought of cartoon manglings, I was also thinking of splints and return-to-work exams. I thought of how many Paramedic and Mountain Rescue skills I could still pull off minus a few working fingers. All this came and went in the twinkling of a few neurons, and, just before the pain blossomed and flared in my hand, I almost laughed.

Crazy, but pain is one of the few sure-fire ways to at least temporarily short-circuit one’s better judgment. There is nothing rational about the first hot blush of pain–in fact, it’s a pretty effective reason-eraser. There’s even less sense or logic about the long drag of chronic pain. The left brain gets pulled into the mess on the back end, when we’re trying to make sense or assess damage or talk ourselves out of feeling the pain. And then they become strange bedfellows, the sensible and the sensual. Primal things don’t take well to fences or leashes or ultimatums, though they can reach a sort of agreement or partnership. A balance. As with all things, balance can accomplish so much more than any one-sided force, no matter how brute.

I read an essay once in The Sun about a woman’s experience being bitten by a rattlesnake. She wrote about refusing pain medication in the early, agonizing hours when the venom was invading the tissues of her leg, and of how important it was for her to experience the fullness of that pain, to know through experience the exact extent of the damage. It’s a trusting, brave, bold way to approach so rich a thing as pain, and it resonated with me.

So maybe all that was there, subtly informing how I reacted in those first few nanoseconds, before I moved on to the just-as-quick realization that opening the door was probably going to hurt more than closing it had. Or maybe I almost laughed because it didn’t hurt that bad after all. That’s probably the most tricky thing about pain: it’s slippery. After it has evaporated or dulled to a background static, it can be damn near impossible to remember what, exactly, all the fuss was about.

The fingers, by the way, are going to be fine. And not at all cartoonish–though, I must admit, that would be a cool party trick.