Saturday, 11 December 2010


Painkillers are standard fare when a person becomes a palliative care patient. The number one priority in end of life care is to keep that person free of physical pain. Around the clock, the medicine does its job; though it doesn't stop the pain from actually occurring, it does stop the brain's ability to recognize that pain. There are other benefits that the drugs provide. In post-operative care, providing pain control theoretically helps a body to recover more quickly. And, for any paitient, being pain free helps to improve a person's sense of their quality of life and in doing so can provide people with mental strength as well. In some cases, a dying person regains resolve and a will to live.

With all the benefits, there are also risks. Pain killers slow down metabolisms, making it difficult for the body to rid itself of waste, and also allowing the medication to build itself up in the body. This means that blood levels must be monitored, as too much can lead to overdose and death. "What does that matter to a dying person?", you may ask. Well, a lot of dying people don't want to die, they just want to be pain free, and to live in that state as long as they can. Painkillers also slow down the Central Nervous System, which slows heart rate and breathing rates, cause fatigue, may cause hallucinations, and can also slow down thought processing. Emotions become numb. So though the benefits can be great, so can be the risks.

But, as we know, there are different kinds of pain. Pain of the heart and mind does not find relief from painkillers**, though addictions to them may mask the symptoms. Many painkillers of this kind are not pharmaceutical at all, but are behaviours and habits one has acquired to block out pain. Examples of such are getting submerged in work and other obligations; countless hours of television, video games, reading, or internet; withdrawing from life; over-participating in life; food addictions; emotional numbness; emotional walls; and an overemphasis of trying to just be "normal". Dealing with it and moving on, but skipping the deal with it part.

Sometimes these mechanisms are used to pass a little time. Then, when the wound isn't so fresh, we can go back and attend to it. But often this is not the intent. Often we kill pain with the hope that it will go away permanently and we will never have to experience it again. The problem is that no matter how many pretty flowers and new sod we put on top of that churned up dirt, roots of old will poke through somewhere, sometime, somehow.

There are too many kinds of pain, and too many kinds of possibilities of what that pain can do to go into things. I am not a pain expert, though I have great experience in certain kinds. But it really struck me how it is such a goal of our culture to be "pain free". Is there such a thing? Is it a healthy thing if it is? And is pain really the worst thing in the world, when in its terrible way it is a direct side effect of love lost? I am going to be bold enough to suggest that happiness is not just an absence of pain, as I'm sure joy is not. It bubbles from a different place. But in choosing to feel at all, in wanting to feel all the good that we sometimes so desperately must, it is impossible to block out the sorrow that rushes from underground.

In summary, if I choose to experience life, I must let myself feel. Painkillers are not meant to be permanent for someone who has a lot of living left to do. If I let myself feel, I can't control what I get to feel. There are some deep rivers of sorrow under the same ground that the springs of delight bubble up from. If I numb myself from the pain, I numb myself from all of that too. Part of healing is hurting. Sometimes a deeper hurt that I would have ever thought was possible a few months ago. I would give or do anything I can think of if it was possible to return what I have lost. But since I can't, I must learn to love life without him. And so I must feel, and so I must hurt. And so I must heal.

**(Please note some illnesses, like depression and bipolar disorder for example, can respond to anti-depressant medications enough to evert crisis and give an individual a chance at wellness. If you may have one of these illnesses, please give it a shot. You've got a lot to lose).


Danielle said...

You have a heart of deep courage my friend.

Amy D said...

Thanks for sharing, friend. Love you.

BD said...

Such powerful words. This makes me think of a poem that moves me:

'Those who will not slip beneath
The still surface of the well of grief
Turning downward through its black water
To the place we cannot breathe
Will never know the source from which we drink
The secret water, cold and clear
Nor find in the darkness glimmering
The small round coins
Thrown by those who wished for something else.'

David Whyte, 1990, Where Many Rivers Meet

Betty said...

My dear niece Sandra - I've just read this entry. I did not notice it before your Mom asked me about it. I will comment on this when I have the strength and courage to do so.
I am so proud of you!
I love you very much.
Aunt Betty