I’m writing this, fresh from about 10 days of intermittent pain from a couple of teeth that decided to act up just after I’d had a couple of others fixed on the other side of my mouth. The dentist is no longer allowed to prescribe Tramadol, my go-to pain reliever for the past several years, because of new rules inspired, no doubt, by the national wave of deaths caused by overdoses of opiates.
Tramadol is a “synthetic opiate.” I’ve never had any difficulty using it when needed and then putting it back in the closet until it’s needed again. It’s nearly always helped. (Not absolutely always.)
I had to wait a week until the dentist (endodontist, actually), who only comes on Mondays, could perform one or possibly two root canal operations. Without the Tramadol, I was thrown back on Tylenol. Reading that safe use of that medication is limited to eight pills a day (no matter your weight, apparently), I finally researched whether Tylenol can be administered in conjunction with ibuprofen. I was glad to see the answer was yes. That has helped, but I think I still pushed the limits, even of the combination, during this period.
Yesterday, I had not one but two root canals because of fortuitous cancellations with the endodontist on his Monday visit, and my fortuitously being excused from the jury duty obligation I’d been scheduled for. It was a day of uncertainty: After the first root canal went off successfully at 9:30 a.m., I was called back because of another cancellation, so I was allowed to finish all the necessary work—and hopefully avoid more protracted pain—in one day!
The doctor, unable to prescribe Tramadol because root canals apparently don’t qualify as dental surgery, upped his previous prescription of Tylenol with codeine to hydrocodone, which he said is the strongest thing he’s allowed to give. I eagerly went for it, only to be disappointed that when I took a tablet at home (and the next time, two tablets), the medication didn’t relieve the dull ache in the molar that had been the locus of the second root canal.
I was thrown back on Tylenol and ibuprofen with the hope that since the root canals were over, the pain would be short-lived and life would return to its more or less “normal” rhythm and tenor soon.
Mental vs. physical pain
I’ve had my share of pain in this lifetime. Meher Baba says that mental pain is worse than physical pain. I’ve had a fair share of both. More than some, but less than others, I’m absolutely sure.
Recently, someone close to me experienced a breakup with a romantic partner. My wife and I commiserated over the phone with this person, able to do so because, well, we’ve both “been there, done that.” I remember the desire to just throw myself in a well and drown the feelings of unworthiness and grief. That was a metaphor, and I didn’t throw myself down an actual well, because of a strong attachment to continuing to live—and God Willing, to love again.
The mental suffering was bad, yes. But the physical suffering during this past week or 10 days, when the pain medication I had access to wasn’t sufficient to dissolve the “bite” of the poisons in my infected gums, was no picnic either. It was a stabbing pain that I did my best to withstand.
In the end, I’d take more Ibu and Tyl, preferring the possibility of an overdose to that minute-by-minute torture of the flesh (and through it, the psyche). I’m a large person, and I kept thinking that in spite of the fact that the caution notes seemed to imply “one size fits all,” surely I could manage more than someone half my size.
More on pain
We tend to go to great lengths when pain is actually upon us. In the throes of one of my protracted experiences of time as something of a torture, with the graph of each second becoming something closer to a vertical line, two revelations dawned upon me:
Pain meditation
I remembered again the Buddhist meditation retreat I attended, back in 1976, at the Insight Meditation Center in rural Barre, Massachusetts. Joseph Goldstein, Jack Kornfeld and Sharon Salzberg, pre-eminent among American Vipassana teachers, were all present.
After a couple of weeks of just sitting on our pillows all day, and alternating that with periods of “walking meditation,” Joseph one day introduced the “pain meditation.” He said he’d learned it from his teacher in India, Anagarika Munindra, and hadn’t thought much about it until, back in the U.S. for the summer, he’d accidentally slammed a car door on his hand. Then, forced by the situation, he applied it to great effect.
The whole of the meditation is to focus on the area experiencing pain and simply repeat to oneself, “Sensations arising and passing away.” According to Buddhist adepts, what we experience as “pain” is actually around 90 percent composed of our fear and our mental efforts to flee the sensations!
As we practiced, meditating on the sensations of discomfort that our muscles had developed from sitting on a pillow in the same position all day for two weeks … I came to experience the truth of what Joseph had said. I began, before very long, to actually experience the phenomena in my muscles literally as nothing more than “sensations arising and passing away.”
The aspect that I might have previously labelled “pain” was nowhere to be found! The experience was that of something like “neurons firing off.” Having become able to go to the root of the sensations with my mind, I found them not at all unpleasant … simply “interesting” to meditate upon.
The only catch now, many years later, is that, although I’ve steadily attempted to maintain a spiritual focus in daily life since that 1976 retreat, my mind isn’t “recollected” the way it was after two solid weeks of all-day meditation. I’m not capable of that. And so I (and for the most part, we as a society) resort to these pharmaceuticals as “angels”; we find that at times, they’re incredibly helpful, and at other times, they can leave us in the lurch.
The opiate crisis
As you’ve likely seen headlines attest, the same as I have, there is an ongoing opiate crisis in America, and likely in Canada and perhaps other countries. Previously, I’d had absolutely no understanding of how so many people could be so careless, so ignorant … I didn’t know what! … as to overdose on narcotic pills and end up forfeiting their lives. My wife Barbara and I lost one of our dearest friends this way, suddenly, a few years back.
I was talking with Barbara about this, as the news show we were watching the other evening was on a commercial break. This talk occurred during one of my recent periods when the medications I had available weren’t adequate to relieve the pains in my mouth.
I’d asked, “What do people do, who have protracted pain and very conditional medication for it? People whose situations are much more protracted and perhaps more severe than mine?”
Barbara said, “What do you think all of these people who overdosed were trying to do? They were just like you! They wanted to feel normal and go on with their lives! They had no adequate way to cope with what they were experiencing. The system left them with only one option, and they did not realize the great danger!”
Those words woke me up! I’m just like the many thousands who were simply trying to hold their own against sensations so unpleasant that they were willing to—indeed, felt they had to—take risks! They didn’t realize how risky their situations were!
Pain can be our teacher
We are all in the same predicament. We all need to be careful! Can we all learn the Buddhist technique I was taught? I can’t even do it myself now! And my life has evolved in such a way that I’m not able to spend six or eight hours a day on a meditation pillow!
C.S. Lewis, author of The Chronicles of Narnia, wrote a short book called The Problem of Pain. I don’t remember the specifics, but has he not, in his title, isolated in four words what is, in one manifestation or another, the entire challenge of life? Physical, mental or spiritual, pain is Separation, Separation is pain.
I don’t have a panacea for any of us right now. Sages have suggested that pain is our Teacher and that “Heartbreak opens the heart.”
We go on, day by day, doing our best.
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image 1: Wikimedia Commons/Wikimedia Commons; image 2: Max Reif; image 3: Wikimedia Commons; image 4: Beezone Library; image 5: Wikimedia Commons (cropped from original)
