Pain or suffering? And joys

There are many definitions of pain, but I have been a nurse long enough to know that pain is a response to some sort of wound, injury or assault, and that it is a warning sign to tell us that something is wrong. There is a great amount of science as to the why and how of pain, but then there is also the experience of pain, which is a different entity. Pain is subjective. B never had an anaesthetic before having a tooth filled, he thought the pain was less troublesome than the side-effects of the anaesthetic, whereas I would never contemplate having a filling without having the injection first. When I used to teach about pain control, I liked to use the definition by McCaffery (1968)¹, that says pain is "whatever the experiencing person says it is, existing whenever and wherever the person says it does". In palliative care, we may not be able to get rid of the cause of the pain, but we can relieve the suffering it causes. It hadn’t occurred to me, though (duh!), until I read Megan Devine’s book², that a similar distinction between pain and suffering can be made in grief, and that is useful to separate the two. She points out the pain of grief can’t be fixed only tended, whereas the suffering can be alleviated. I could see the logic of this, but I must admit, I was having trouble trying to work out the application. I think, in difficult times, my approach has been to ‘go through things’ in the hope that it I will reach some resolution, rather than trying to make it easier for myself.

On Sunday, however, I realised that reducing my suffering can be a kindness. One of the hymns at church was ‘Empty, broken here I stand’, written by a couple following a miscarriage. It is a beautiful, poignant hymn but, at the moment, I can’t stand in church and sing it without crying. Similarly, one of the readings was Psalm 88, a rare psalm in that it offers no hope - to give you an idea, v.4: “I am counted among those who go down to the pit; I am like one without strength”; v. 18 “You have taken from me friend and neighbour - darkness is my closest friend”. This was too hard! I decided to remove myself during the hymn and then the sermon (I will listen to it at some point, and I know there will be hope in it), but I couldn’t do it on Sunday. I went for a walk instead. Going for a walk, didn’t lessen my pain, but it did lessen my suffering and I felt the benefit of not putting myself through the wringer. I know I’m in pain, I don’t have to make it worse! Saying that, church is still one of the hardest places to be, but I want to be there, so with that I shall persevere. I may just have to keep stepping out for a while…

In my mind, I have been anticipating December and January as potentially difficult months – our wedding anniversary (it would have been our silver), Christmas, the New Year (B was a Scot, he always liked to see it in and then later watch the New Year’s Concert from Vienna), the anniversary of B’s death… Somehow, though, I had missed some lesser (?!) events as triggers of my grief, and then boom! They hit me in the face. One was the six-month anniversary of B’s death, and the other was my birthday, which is next week. I hadn’t really thought about my birthday much, just that I would be with my family and that we would celebrate my sister’s and my special days (her birthday is the day before mine), as we have done so many times in the past. Then last week it hit me, this will be my first birthday without B and suddenly it took on a whole new complexion. My birthday becomes another painful event! Obviously, I knew B’s birthday would be tough, but why it hadn’t occurred to me that mine would be too, I don’t know. B was always good at birthdays, buying apposite presents, taking me out for a meal or for a special trip. In the more recent years we would plan special occasions together, checking out what each other would like to do, although B always let me make the decision. I guess he knew that I put more store in these things than he did but, basically, we would do something we both enjoyed. Now, it is another of those big firsts!

And then there’s the roof repairs and windows replacements – this is still dragging on! It seems to take so long to get a quote, and then the specifications are wrong (!), and then I find it difficult to make such big decisions on my own, and every time I wake up I’ve changed my mind about which is the best company to go with, blah, blah, blah! And time is moving on – I want / need to get them done before the colder / wetter (???!) weather sets in. So this week I girded my loins and engaged firms to do the work. Then though, I had to spend what seemed like an age choosing the design of the front door, the colour, the type of windows, the type of lock, the type of letter box, and so on, and so on. I wasn’t really aware how stressful I was finding this until I felt the nausea rise and I actually became dizzy (another symptom of grief, apparently)! Ordinarily, this isn’t something that would affect me, and so I found it very surprising that trying to make these decisions had such an impact on me.

Some weeks ago I agreed to do some work for the hospice where I used to work. I was feeling more upbeat when I agreed to this, and then this last week I started to doubt myself. Can I do this? What if I can’t cope? etc. It’s not the work itself, I could do that in my sleep, but rather my current emotional state and tiredness, never a good combination. If I’m honest, the only thing that stopped me backing out was the concern that I would be letting my colleagues down. So, I gathered myself together and went and taught. And it was fine. It was good to see various colleagues, and it was good to teach eager learners, and all in all it was a good couple of days, although I did find it more tiring than I was expecting. 

So the lesson I have learnt this week is that ordinary activities of living take a greater amount out of me at the moment, and that I get both more tired and more stressed than I usually would. Also, I need to get the right balance of being on my own at home and going out and / or being with others. I need to balance the stressors. I don’t mind solitude, I’m an introvert, but sometimes you can have too much of a good thing. This week, work served as a healthy distraction and helped to give me a boost, and for that I am grateful. 

To finish on a positive note, I recently came across this quote by Dean Koontz. I think it’s beautiful and found it very helpful:

“Grief can destroy you – or focus you. You can decide a relationship was all for nothing if it had to end in death, and you alone. OR you can realize that every moment of it had more meaning than you dared to recognize at the time, so much meaning it scared you, so you just lived, just took for granted the love and laughter of each day, and didn’t allow yourself to consider the sacredness of it. But when it’s over and you’re alone, you begin to see that it wasn’t just a movie and a dinner together, not just watching sunsets together, not just scrubbing a floor or washing dishes together or worrying over a high electric bill. It was everything, it was the why of life, every event and precious moment of it. The answer to the mystery of existence is the love you shared sometimes so imperfectly, and when the loss wakes you to the deeper beauty of it, to the sanctity of it, you can’t get off your knees for a long time, you’re driven to your knees not by the weight of the loss but by gratitude for what preceded the loss. And the ache is always there, but one day not the emptiness, because to nurture the emptiness, to take solace in it, is to disrespect the gift of life.”

I definitely have the ache, and I’m currently still on my knees because of the weight of the loss, but I know this will gradually change. I am, and will always be, so grateful for B, for our time together, for all he gave me and how he enriched my life, and for all we shared, “sometimes so imperfectly”. I hope he knew that. I hate the pain, but I wouldn’t swap it. What we had was precious and one day I will be able to celebrate it without the emptiness and grief. He would want that for me.

So, in all of this there are joys: my family, who will share my birthday; the trust and friendship of my colleagues; on a lesser scale, that my roof and windows work is now in process (although I may not be so happy whilst they are being done!); but, most importantly, my life with B, and all we shared, imperfect or not. I remind myself that it is worth this pain. And pondering on all of this, a very obvious thought struck me, but I almost missed it as I take it so much for granted these days, I continue to bear his name. A part of him that I carry with pride.

References:

1. McCaffery M. (1968) Nursing practice theories related to cognition, bodily pain, and man-environment interactions. Los Angeles: UCLA Students Store.

2. Devine M. (2017) It’s OK that You’re not OK: Meeting Grief and Loss in a Culture that Doesn’t Understand. Boulder, Colorado: Sounds True.