BETWEEN 1 AND 10, HOW MUCH OF A PAIN IN THE ASS AM I?

Luckily, I have never had a nasty, bone sticking out, compound fracture. I’ve also never been hit by a speeding (or slow moving) bus. Nor have I ever been shot with a large caliber gun, stumbled off the side a tall mountain cliff, or had a house fall on me like what happened to that Eastern witch with the snappy red footwear while she was slumming in the Oz suburbs. But even though I have not personally experienced any of those unpleasant things, I think I can still safely assume all of that stuff hurts… A lot… A whole lot. And a thought similar to that, is what always pops into my wandering noodley noggin whenever a medical person flatly asks me “between 1 and 10, how much does it hurt?”.

My wife and I are talkers.  We can happily dissect every aspect and angle of the inanest subjects for hours and hours. I mean, we once contentedly spent an entire 90-minute car ride having a rousing discussion about what a good Americanized Chinese food restaurant should visually look like. You know, plastic covered red vinyl booth bench seats, paper placemats with caricature sketched illustrations describing each Chinese horoscope sign, a Buddha statue with loose change tossed around it, a chaotically messy cash register counter, slightly dusty hanging red faux lanterns, at least one curved doorway, gold painted wide-spaced grid-like wall panels loosely framing sporadic non-sequitur Asian symbols… 

With as much talking as we do, rerun conversations are bound to happen. And one of the most repeated discussions we have had is about how impossible it is to accurately answer that ‘how much does it hurt’ question. It consistently comes up after one of us has a medical appointment.

Unless you have experienced every feasible, possible type of agony, how could you possibly know what a 10 level of pain is?  If nothing that bone-crushing or body-mangling bad has ever happened to me, I might think a stubbed toe or a weeks’ worth of constipation is a 10. But then I might fall off a ladder and go ‘whoa, this is obviously a 10’.  And that might all be fine and dandy until I have a Wyle E. Coyote experience on a sky-diving trip where my Acme parachute doesn’t open and the ground and I have a rather harsh impetuous meeting.

Surely that sloppy smushing would supersede any previous ‘10’. But even then, would I really know for sure that there was not anything worse lurking out there. The internally explosive ramifications of taking an oxygen-less morning stroll outside the International Space Station dressed only in boxers, flip flops, and open bath robe might hurt even more. Not that I am planning any out of orbit trips in the near future to find out, but conceptually, that is a helluva way to go. It would certainly earn the respect of The Big Lewbowski’s Dude, but is it a 10?

You see, asking someone to rate their pain between 1 and 10 is like questioning someone ‘how long is a piece of string?’ You don’t really have all the information needed to properly answer. And to make it an even more ridiculous question, you have the whole tolerance of pain differences between people. My 9 might be someone else’s 2, and we have absolutely no possible way of knowing who is closer to correct. Or what correct even is. It’s just a made-up scale of measurement that is as subjective has how funny a comedian is. It’s completely different for everyone. Not to mention that previous experiences and current mood can affect how you feel about pain or comedy.

It’s not like when an optometrist asks which lens is less blurry, or an audiologist has you raise a hand like a needing-to-pee first grader when you hear the tiniest of meek beeps. To those medical questions there is a set singular undebatable answer for each person. And those results can be easily compared to anyone else to accurately diagnose how deaf or blind you are compared to any or every other person. I mean, I’ve had one of those Sleep Number beds for 10 years and I still can’t decide what number is optimum for me to snooze on. If I can’t even do that, how could I ever be expected to explain my pain with an arbitrary number?

So, for the past few months my legs have hurt. Now I might have no friggin’ clue how bad they hurt on a scale of 1 to 10, but it’s been bad enough that I went to a doctor. But even that is subjective. I once worked with a true hypochondriac that thought every minuscule out of the norm feeling they had, called for a doctor’s visit and a battery of specialist’s tests. This happened so frequently that they single-handedly threw off the averages and caused our company’s insurance premiums to increase.

Obviously that person was more sensitive to the aches and pains we all experience, but just like how they thew off our medical costs, you have to wonder if folks like that are also biasing doctors themselves? If I waltz in and I conservatively say my pain is a 5, while everyone else says the same thing is a 9, will the medical practitioner assume my pain is not as bad as the last guys?  Like someone cheating the system by subtracting a few strokes from a golf score card to get a better placement in the next round, should I be hedging up my score of how much I think something hurts, to make sure a doctor treats my pain as effectively as someone else’s?

I was a bit late on getting my yearly physical anyway (is it still called a yearly physical if you procrastinate it by 3 years?), so when I finally went in for that, I told my kindly doctor about my achy legs. She of course asked THE question. I paused and said “6, maybe 7” but then as usual, I explained my problem with the 1-10 pain rating system. Then I went into my obligatory usual rap about how I think I have a high tolerance to pain but that I am not really sure. Since my wife and I have rehashed the ridiculousness of that 1-10 pain question thing so often, I have my speech down pat.

I told the doctor how I busted my nose when I was three, but my memory of that was of my siblings teasing me, not of any pain. I cracked a rib in junior high, but that only really dropped me to the ground in massive pain when a teacher that didn’t know I was taped up, punched me in the chest for making him look like fool after playing a prank on him in the lunchroom. When I tore a tendon in my leg taking off in a footrace at a 5:00am bootcamp exercise program, I not only still finished the sprint, but won the race. Then I worked on my feet for two days afterwards, till my coworkers demanded I see a doctor about my swollen throbbing calf.

After I finished my long, drawn-out story, my very tolerant doctor recommended I see an orthopedist. I’m still not sure if she did that because they might better assist me, or it would simply get me out of her hair with my whining about the 1 to 10 thing. All I know is the next day, when I saw the specialist’s assistant in the pre-examination room, he asked me the same damn infuriating 1 to 10 question.  As did the actual orthopedist, the X-Ray technician, the MRI operator, and the physical therapy guy I’ve been seeing the past couple of weeks. And they all got to hear me gripe more about the pain question than the actual pain.

Forget about the dozen years of college and interning, repeatedly hearing people complain about hurting has to be the toughest part about being a doctor. I know it’s the job, but it has to get really tiring. I’ve obviously gotten to the age where one of the first conversation topics that comes up whenever I get together with old friends or family, is everyone’s aches de jour. I know how repetitive that feels to me, I can only imagine how it must be for a medical person whose every conversation with every patient, all day, every day, is about how much pain they are in. And frustratingly enough, I bet they are really only able to successfully treat that pain for a small fraction of the complainers, the rest are just taught ways to manage or live with it.

It’s understandable though. I think most people have abused the daylights out of their bodies in one way or another. And while I might not have done anything as extreme to myself as that over-the-top, bathrobed spacewalk, I know I certainly have not always done the right thing for my health. I’ve taken advantage of the fact that I am from good, long-living healthy stock and certainly done my share of stupid activities. I have a hunch that the lower spine nerve issue causing my achy leg thing is part of the paying the bill for my previous self-abuses. And while that might not make me feel any better; it does explain a lot.

So the other morning at the PT place, while doing some wacky exercise in front of all the other patients getting their own treatments, where I slip on a tight rubber elastic band and walk across the floor like a waddling duck doing a ska dance, I had an interesting thought. If for just one minute we could all feel each other’s pain, I wonder how that would affect the way we rate our own discomforts. Maybe it would make us more deeply sympathetic to others. Or make us appreciate how good we might have things. Or maybe it would not change a thing. I understand that to each person, their own personal pain is the worst… because it is the burden they have to bear alone no matter how much harder or easier the next guy has it. I guess at a minimum, it might at least give us a realistic way to rate our pain on that stupid 1-10 scale

Luckily, I think my achy legs are starting to get a little better. And maybe if I actually followed my doctor’s instructions and took it easy instead of foolishly doing massive heavy back-breaking post-storm yard work like I did last weekend (to my credit they never specifically said not to drag oversized fallen branches to my yard use a chain saw on them for an hour and half in the 95 degree heat), I bet I’d feel even better still. But I’ll keep trying to strengthen the weak parts and treat the painful parts and maybe, just maybe I can get things down to a four… or three… or two…  or one… or whatever ‘relatively pain-free’ is on that damn 1 to 10 scale.

STAR TREK – THE DEVIL IN THE DARK…. “HORTA.. PAINNNNNNNN”