Have you ever been in pain? Not the annoying pain of a paper cut, or when your hammer misses the nail. I’m talking teeth-gnashing, stomach-churning, cursing-like-a-sailor pain.
Males and females have their own versions of ultimate pain. For females, it’s the agony of childbirth; for males, getting wracked in the testicles. Since I swore off children and lack a scrotum, I’m a virgin in both realms. But that doesn’t mean I haven’t experienced pain.
I suffered a few serious mishaps as a child (see April’s Disfigured), but fortunately the pain
associated with those injuries has been blurred by time. Since then, I’ve
experienced true pain on only two occasions.
The first was the twelve hours I spent writhing in bed until
my appendix finally burst (which ironically brought me a bit of relief). The
second was a week later when the swelling in my belly caused my small intestine
to crimp. HOLY MOTHER OF GOD!! It made the appendicitis seem like a day at the
beach.
What exactly is pain and why are we equipped with such
reflexes? Let’s explore…
Pain is a physiological response to noxious stimuli that
warns us of danger. It comes in two forms: nociceptive and neuropathic.
Nociceptive is what we typically think of as pain – nerves activated by insult
or injury that send signals to the brain. Think of burns, trauma, or
inflammation. Neuropathic pain is caused by damage to parts of the nervous
system and is frequently chronic, meaning it can last for years. I can think of
nothing worse…
Well, maybe one thing: the inability to feel pain. Known as
congenital insensitivity to pain (CIP), this genetic disorder leaves its
victims unable to distinguish true pain. The disorder affects the peripheral
nervous system, leaving the person with a disconnect between the central
nervous system and the nerves that detect sensation. The result is a shortened
lifespan due to an accumulation of injuries and medical problems that go
undetected. How would you know you were having a heart attack if you couldn’t
feel the chest pain?
Pain comes in many forms and the type or characteristic of
pain can aid in diagnosing the underlying problem. Is the pain acute (sudden)
or chronic (ongoing)? Radiating or non-radiating? Is it sharp or dull? Pinpoint
or diffuse? Stabbing, piercing, throbbing, searing? The answers help weed out
differential diagnoses.
As a medic working Orlando’s west side, pain was part of our
toolkit. The homeless are crafty when it comes to devising reasons to go to the
hospital, where a warm bed and hot meal await (can you blame them?). Delivering
noxious stimuli to transients feigning unconsciousness was part of every shift.
We were masters at the sternal rub – knuckling someone’s sternum to make them flinch.
Only the most skillful actors evaded our assessments.
But what about mixing pleasure and pain? (You were hoping
I’d go there). I’ve never ventured into the dark closet of sadomasochism, but
apparently there are a whole slew of folks who simply love the leather. So I
read up on the subject (I’m up Shit Creek if the FBI ever reviews my Google
searches). According to Psychology Today, S&M is all about "power and
control" and is far more prevalent than we realize. It comes down to role
playing. The sadist wields the pain; the masochist is happy to receive it. Hey, as
long as it’s between two consenting adults, have at it.
I’ll leave you with a curious tale about pain (or lack
thereof). A patient of mine, although drunk and with his leg in a cast,
decided to take a ride on the back of his friend’s motorcycle. Unbeknownst to
him, the fracture had damaged certain nerve pathways in his foot. After a few joyful miles,
he happened to look down and realize his foot had slipped from the pedal. He had been dragging his damaged appendage and subsequently ground off two of his toes.
Like I said - pain is a good thing. So the next time you
experience a mishap, remember that pain is your body’s way of communicating. I
strongly recommend you listen.
Preview: Get out your notepads, boys, for next week we’ll be delving into the female anatomy. Join me as we learn all about the lady-parts.
