Defying the Pain Scale

The darker the night, the brighter the stars,
The deeper the grief, the closer is God!”
― Fyodor DostoyevskyCrime and Punishment

Pain. All of us have experienced it to varying degrees. In recent years pain has been identified as the fifth vital sign – the first four being blood pressure, pulse, respiratory rate and temperature.  And thankfully we have come to recognize how critically important it is to know how to assess pain.

In western medicine we have something called a “Pain Scale”.  This scale was developed as a tool to help assess pain in patients – whether it be after surgical procedures, during emergencies, and in illness in general. Beyond the verbal assessment where a nurse or medical doctor asks the patient questions like “Are you in pain? Can you tell me where it hurts? Is it a sharp or a dull pain?”  the scale adds a numeric instrument to assess severity:  “On a scale from 1 to 10, can you tell me how severe the pain is?” 10 would be the absolute worst pain that you have ever experienced and 1 would be minimal to no discomfort. The rationale behind this scale is to have a reference point understood by both clinical staff and patient.

To a point this scale is a good, all be it culturally biased, measure.  Because we all have different levels of pain tolerance, it is helpful when the clinician is trying to make sure that the patient is comfortable and has proper pain relief.

But there is some pain that defies the pain scale. Some pain that is so far beyond a scale that using numbers seems ludicrous. Pain that goes beyond the physical and involves the emotions, the soul.

I have a friend whose pain defies the pain scale, whose heart is broken into a million pieces. She is betrayed and wounded and her soul knows pain. Those million pieces are each like jagged shards of glass that keep on wounding over and over. Beyond the pain is the grief…grief for what was, what will never be again; trust and comfort lost and replaced by a false and poor substitute. All the king’s horses and all the king’s men can’t mend her heart. Her pain defies the pain scale and her grief defies the grief scale. Her symptoms include frequent swallowing and an empty feeling, she sits down to a meal and though she is hungry, she can’t eat. She sits vacantly at her desk, unable to function. She  has soul tears that are so deep she can’t cry. It makes the scale a laughable, fallible tool with a limited use.

What do we do when our pain defies the scale, defies our human understanding. C.S. Lewis in his beautiful book, “A Grief Observed” tries to get a better grasp of these emotions. Although it is about grief, it resonates on pain as well.

“No one ever told me that grief felt so like fear.” he says at one point. “I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing. At other times  it feels like being mildly drunk or concussed. There is a sort of invisible blanket between the world and me. I find it hard to take in what anyone says.” and then “You can’t see anything properly while your eyes are blurred with tears.”

Defying the pain scale is nothing new. The Psalmist David had pain and grief that defied any scale. Job had pain and grief that defied any scale. And surely Mary, as she watched her precious son on the road to Golgotha, surely this was pain and grief like no other.

So I take hope – for when our pain defies the scale, this is when God Himself steps in with his comfort and love. A comfort and love that are stronger than any man-made and laboratory-developed  pain relief; a love of the sort that defies any cliché; a love so strong and a comfort so deep that this alone can speak to the pain that defies a scale.

“But suppose that what you are up against is a surgeon whose intentions are wholly good. The kinder and more conscientious he is, the more inexorably he will go on cutting. If he yielded to your entreaties, if he stopped before the operation was complete, all the pain up to that point would have been useless.” CS Lewis A Grief Observed