The word pain literally means “ a highly unpleasant physical sensation caused by illness or injury”. If so, what I experienced during the first 3 months of my treatment was something much more than unpleasant or physical. It was a constant affliction that pervaded from the site of injury ie.my right foot upwards to my head. The most agonising moments were when the pain spread stealthily to your mind causing a numbness and freeze hitherto unknown to me in all the 52 years of my life.Being a person prone to resist and disagree with any kind of discomfort this phase of my life taught me many a hard lesson. It set me wondering if one really had to go through such hard times to realise some simple and obviously handy attributes that make life easier and liveable.But I was chosen by some force to know it the hardest way.
My first experience with intense pain was in the naturopathy centre where I took refuge from the “ merciless and invasive” world of modern medicine that I had such unreasonable hatred about. It was only much later ( and tragically at a late stage) that we knew that the burning sensation and color at my ankle joint was due to necrosis when almost all living cells were dying due to the injury, lack of control of infection and total stoppage of blood supply. The foot was like in a furnace and the burning was so intense. Here I experienced the first redefinition of pain. I was told that pain is good- a sign of life and vital life energy.I forced myself to believe it and put a wet cloth on the area above the source of pain. Having cucumber juice and some fruit juices many times a day,I was also told that cooked and hot food would increase pain. In spite of the chill in the air due to rains and my own low basic metabolic rate due to hypothyroidism, I tried to believe that hot food would elevate the pain…who would want that even if it is good to be in pain?
The “merciless cutting “ of layers of slough (it took me a few weeks to get the spelling of this word that ominously meant the layer or mass of dead tissue that overlays the living tissue as in a deep wound) that took a month or more to subside was what was creating the pain. I realised that no injection would work on this dead layer..so whenever the cutting touched the live tissue I would be thrown into the “labyrinth of pain”. It was not suffering, torture, agony, torment, discomfort that I felt.It was a sensation that spread from my body to my mind. If there is something called self- confession, I did it thousand times a day remembering the words and gentle coaxing of 2 good friends who kept asking me to take a second opinion, the pain and confusion in the face of my sister, the anger with which my lady help would plead with me to go to a proper doctor…all their concern fell on dead ears..yes, my dead ears and how else could I plead mercy than to confess silently?
Then started the phase of redefining pain that has become a learning for life! As I cried silently and then loudly as the young house surgeon’s deft hands and soft voice persuaded me to withstand the ordeal. After the cutting which went through various stages and levels of pain, the washing with betadine and hydrogen peroxide would evoke another feeling or sensation of pain. I realised that there are not many words in the vocabulary that would make writing about the diverse and subtle kinds of pain I experienced. Then the dressing stage which was a relief would start that meant the end of that day’s cleaning operation. One day I asked the doctor in anger “ Why call this modern medicine? Is this not primitive- the cutting of flesh raw?” He smiled his gentle smile, took a piece of paper and wrote the name of an analgesic spray. As if the message reached my mind that was reacting more than my body to pain, the spraying of this around the affected part would ease the torture a bit.
The worst part was the pain that would enter as your foot relaxed after an hour of cleaning and dressing. This was almost always just before lunch hour and it would hinder my eating. I took pains not to frown and cry for fear of hurting the dear ones who would be keeping me company. The kind sister in charge during that time would come enquiring if I needed a painkiller injection. Of course yes, I would whisper wanting my foot to be taken off the oven where temperature seems to have been set at maximum. The injection would go in causing a strange dizziness in my head, a nausea in my mouth and a weakness that was almost like a hallucination. My reasonable mind would ask “ Can a medicine start acting so fast?” But the action that is expected of the medicine – to reduce pain – would take long to come!
It was then that I discovered that the medicine being given was the ill famous Diclofenac! My sister and me had earlier gone into lengthy discussions about the impact of this on vulture populations in India and Pakistan. Understanding and coping with my pain assumed a new meaningful dimension after this. To know that veterinary use of diclofenac in livestock especially cattle had affected the population of 3 species of vultures nearly driving them to extinction is a tragic chapter in the understanding about how delicate the balance of nature is.Scavengers like vultures play a big role in the disposal and elimination of waste especially of carcasses in major part of India and Pakistan. The treatment of livestock with diclofenac that suppresses inflammation and infection has been in the rise since 1990.It was since then (1993-2002) that 99.7% of white rumped vulture population along with 97.4% of Indian Vulture and Slender billed vulture vanished.Postmartem analysis of dead birds showed residues of diclofenac and visceral gout that is a sure sign of drug poisoning leading to death. The detailed studies done by scientists in India and Pakistan led to banning of diclofenac in 2006 and introduction of a substitute Meloxicam that has no impact on vultures. The ecological impact of declining vulture populations due to diclofenac usage was what hastened the decision to ban the drug. The vulture gut is a dead end for pathogens and consumption and removal of cattle carcasses would mean the cutting of spread of many diseases. As vultures went, the space was taken up by mammals like dogs and rats that became carriers of many epidemics like plague, anthrax and rabies. The natural niche of a scavenger occupied efficiently by the vultures can never be compensated for by any other being. The saddest part of the story is that even now the diclofenac that is available for human use is illegally used for livestock disease control. The threat to vultures will continue as long as we,humans use diclofenac .
These thoughts filled my mind most when I started refusing to take the pain killer injection.But I would not be truthful if I claim that it is this ideological position alone that prompted my refusal to take Diclofenac. It is here that my next tryst with pain started …the pain I felt due to the mechanical cutting and pulling accompanying slough removal could be decreased a wee bit with the drug. But as the healing started in 3 weeks time, the pain of new tissue forming- a life saving word I learnt during those days- Granulation started. This creative process when my leg was being reborn was accompanied by a deep and regenerating pain. I realised as a few days passed that this pain could not be reduced by a pain killer.My doctor suggested an oral tablet which he promised would start acting within 20 minutes and last till 2 hours. But even that did not take away the pain of granulation. It was this that actually made me refuse the drug. The nurses in charge were shocked with my decision..they would exclaim” all patients are crying for a pain killer and here we have one who refuses it”. Not wanting to tell them that their wonder drug for all pains is ineffective, I would narrate the story of the vultures who almost lost out on life because of our mindless use of a drug. They would walk away,half convinced with my story.The best part was when my sister told about the vulture and diclofenac to a post graduate student-doctor who showed exceptional aptitude and willingness to learn about new things.It took her a while to understand the seriousness of the information. She first giggled and swung her hair with unusual energy while commenting “ Oh, how very intresting..vultures dying due to diclofenac?” Then in a minute her face grew grave and she said “How little we know about the impact of our actions on the surrounding world! I am so grateful that you told me this”. This was a big learning not only for her but for us too!
It was during these days that the thought provoking words of Rumi reached me “ The wound is the area through which light enters your body”. If this is so, then the deep wound in my foot really let in a lot of light and calmness into my mind. During the long hours of pain and suffering, I felt a very special feeling of calmness descend into my mind and body. There were many moments when I lost control, cried out loud and even kicked my injured foot up in anger and sorrow.But most of the time I was peaceful and inwardly preparing for a transformation.
The words of a dear friend with whom I shared the various subtexts of physical pain that collided with the mind heralded the emergence of the metamorphosis.He wrote
“ There was a time when artists added ‘ting’ to pain so that a painting is born. Today we add ‘ing’ to paint to make a painting”.
These lines opened up a new arena whereby I touched upon how pain can be the birth of a new being, create a positive energy and feel in you.Like a woman who has gone through the pangs of child birth and who forgets the long torturous hours of labor the moment she sees the baby’s face and touches the tender fingers, so I too started the journey down the corridor of pain. The trolley with medicines that would come down the corridor announcing a painful dressing session became the “ chariot of healing” rather than of pain. The tall,hansdsome doctor who attended on me would refer to the clink-clank of the trolley as “flight arrival time has come.prepare to board” and we would share a laugh! We would assign roles and names to each of the characters in the stage of healing that was being set in my room- there were heroes, heroines, villains- both male and female, healers and offenders …many were eager to know who was which and I would hold the secret of the story with glee and mischief.
The verbal input that another dear friend shared about pain took root from the words of Mother from the Aurobindo Ashram. He quoted from her words
“ If we eliminate the mental factor, the body left to itself has has neither fear or apprehension or anxiety about what is going to happen- no anguish- and it can bear a great deal. The second step is when the body has decided to bear it- it takes the decision to bear it, immediately the acuteness, what is acute in pain disappears. And if you are calm- if you have inner calm, then the pain changes to an almost pleasant sensation- not pleasant in the ordinary sense, but an almost comfortable feeling comes in. “
This must be what came over me soon after the first 2 weeks..a deep feeling of pleasant quietude. I did not want to see many people during those days and made enemies of many who felt that I had rudely rejected their care and love. How could I make them understand that I needed all the focus and concentration to take in the pain? I did not want to forget or get distracted by the waves of suffering that was engulfing me. I wanted to experience it fully, not sublimate or escape but ride in it full speed.My dear sister alone understood this fully and boarded the chariot of pain with me all the while!
I hated my friend who wrote me a long letter for what I felt were hollow words.They did not pacify me at first but as days passed the enormity of what he said sank in like the pain molecules start the limb building in me
“ This will renew, cleanse, renew your energies- like the rivers that bring good minerals, soils, water into the oceans or the mountains that open a new niche for a plant, a habitat to grow, sustain,live and enjoy. You will soon enter the world of total welllbeing”
He drew a life chart for me and made me see all significant phases in my life through the most vital of body organs- the limbs. The quadripedal being that evolved into the bipedal is one of the most unique phenomemon. And only by losing the capacity to stand on your 2 legs would one realise how important it is. I was constantly reminded of worse situations- whether it be of incapacitation or pain. Many a time this did not bring much relief but it gave me a chance to look inward, introspect.
This forced rest, recuperation and recovery also made me reflect on myself. And pain and the redefining of pain along with the understanding of the marvel called the human body together with the human hands and mind that work to repair it…it was a reconnaissance about Anitha- my past, present and future!
30th Dec 2016
Anitha S is an social activist and an environmentalist.