Ultimate Reality

I showed up at the Student Health ENT Clinic fresh from my second-year lectures about the anatomy and physiology of pain.  Since my undergraduate degree had been in psychology, I also felt that I had an edge in understanding the emotional component to pain.  Though pain was on my mind, the reason for my ENT visit was the aggravating but nearly painless problem of persistent otitis externa–swimmer’s ear.

Interns and residents, bright, knowledgeable young men and women lacking only experience, staffed the Student Health Service.  Being all of twenty-three myself, I was convinced experience was highly overrated, and happy to accept the free and convenient care.

“No problem,” the resident said.  “You just sit here and I’ll curette out that wax and debris.  You’ll feel better in no time.”

I relaxed.  He curetted.  And in ten seconds I experienced the most intense pain of my life.  I jerked away and stifled a scream.

The resident told me to stay still.  I relaxed.  Pain is a state of mind, I told myself.  Mind over matter.  I willed myself into an immobile zen-like state.

He curetted again.  I jerked away again.  We repeated the scenario multiple times.  In the end, I still had otitis externa, and now a whole new understanding of pain.  There is no mind-over-matter.  There is no zen-like state.  Pain is pain.

A few years later I took care of an old man with a compression fracture of his thoracic spine.  His fall had been minor, and osteoporosis had made him susceptible to such fractures.  The important thing, I kept telling him, was that his spinal cord was in no danger and these injures always healed with time and rest.  But it hurts bad, he told me.  So I gave him a generous prescription for narcotics before he went home from the hospital.

A few weeks later I saw him in the office.  “It hurts bad,” he said.  I asked if the pain medicine was working.

“Not taking it,” he said.  “It’s narcotics.  I don’t want to be no dope addict.”

I assured him that he would not get addicted using the medicine only while he was healing.

He looked doubtful.  “How long?” he asked.

“Six to twelve weeks,” I said.  “From the time of injury.  Another month or two.  No more.”

He gave me the same skeptical look, but this time shaded with something darker.  “I don’t know if I can take it,” he said.

“Take the pain medicines,” I told him.  “Rest.  Be patient.  You’ll be fine.”

I wasn’t worried.  In a few weeks he would be back to normal, which for him involved caring for his rural cabin where he spent his life hunting and fishing.  I had no reason to think this would not be his future.

A few weeks later, his wife called to tell me he was now in great distress.  She was afraid for him.  I got him on the phone.  “The pain’s so bad,” he said.  “I don’t think I can take it.”

I asked about the pain medicines.  He wasn’t taking them.  I reassured him and asked if he wanted to come back to the hospital.  He didn’t.  I got his wife back on the phone and told her to bring him in if it got too bad.  She told me that I didn’t know what he was like.

“He will be okay,” I told her.  “The pain is temporary.  He will heal.”

Two hours later Rescue called from the patient’s kitchen.  He had shot himself in the chest with a shotgun, aiming for the painful fracture site which was located immediately behind his heart and aorta.  He was dead within minutes.

He possibly would have been okay if he had taken his narcotics.  He possibly would have been okay if he had come back to the hospital.  He certainly would have been okay if he had been patient, if he would have–could have– given himself the time to heal.  If only he could have stepped outside of time and stepped back in a few weeks later.  But instead he was dead, a victim of the white-hot obliteration of rational thought and panic induced by uncontrolled pain.

Pain is the ultimate reality, psychiatrist Jordan Peterson stated.  None of our philosophies or religions or meditation strategies can completely take us out of our physical state in this time-space-matter continuum, and nothing drives that point home more poignantly than pain.

Often a patient with a concussion experiences something like stepping out of time for a day.  This concussion patient suffers an injury then a quick return to consciousness but with amnesia for the traumatic event and events several hours before.  He then loses the ability to retain any new information for the next twenty-four hours.  He repeatedly asks where he is, what happened to him, how long he’s been there.  After their questions are answered, almost immediately he will repeat the same questions.  It is as if time now stands still in his mind.  He remembers everything up to one moment, then nothing new.  Nearly always he will return to normal the next day.

The curious thing is that patients with this type of concussion rarely complain of pain, even if they have suffered a broken bone or worse during the traumatic event.  But the next day, when memory returns, pain returns.

Pain, therefore, seems to require us to be conscious of our place in time.

Which brings us to Jesus.

If God is God, and created the universe, one hundred billion galaxies with one hundred billion stars each, and God is all-knowing, and He exists in eternity, that is, not simply forever but outside the limits of time, then God knows of pain but does not experience it.  Yet, He made a decision to not let one species on one tiny planet circling one middling star in one middling galaxy, destroy itself, even if it cost Him some mystical transformation into flesh and time, and, yes, pain like that white-hot thought-obliterating, panic-inducing pain that would cause one to blow their heart away with a shotgun.

So this is the miracle of Christmas: the Creator of the Universe chose to experience pain like yours so that you could experience love like His, and someday you, too, can step into eternity, outside of time and outside of pain.  And into great joy.