the rhetoric of pain

Music: Aztec Camera: Knife (1984)

Sitting in the middle of a buffering, hydrocodone haze, in that unfamiliar echo chamber of the muted screeches of chronic pain, this post comes. The pain is neither wicked nor the consequence of some misdeed, but rather, and complexly, a result of a genetic disposition finally flowering.

In my foot.

I'm enduring my second bout of gout in as many years, a largely genetic form of arthritis caused by a build of uric acid in the blood. "Gout," interestingly derived from the medieval Latin gutta meaning "drop," got its name from the not-too-far-off idea that the pain was caused by the blood depositing disease in the body's joints. The disease was thought to afflict only the wealthy (and obese), who could afford the kind of rich foods that contribute to the build-up from uric acid (red meat, shellfish, and other foods high in purines). When I was first diagnosed---after mistakenly thinking I broke my big toe---I thought somehow my diet was to blame, at that time a high protein, low-carb attempt to maintain my weight (obesity is also a family issue stretching way back on my father's side). But I've since learned from my doctors that diet is not the causal factor in most of the afflicted: it's genetically predisposed in a majority of the cases, exacerbated by diets rich in purines. I've had a relatively healthy diet since that time (mostly eat fish and chicken as my proteins these days, with a steak every four months or so) and exercise daily, but still, that doesn't mean I have avoided the affliction. Once you have an attack, you have the disease and are prone to "flare ups" for the rest of your life. My mother reports that father used to get it pretty bad (managed well today), but I don't remember that. My grandfather had it much worse; when I was a kid, I can remember his swollen elbows and his immobile posture on the couch watching reruns of Matlock . . . .

After enduring the pain for four weeks, and after various meds, some helpful some not-so-much, I finally had enough and went in today to get a cortisone shot directly in the toe to speed the healing. Apparently the pain from this kind of injection is almost unbearable, but one has no choice but to bear it for the benefits to come in a couple of days (they give you a "bullet" to bite on). Sitting in the doctor's office today, feeling dopey and playing the new version of Bejeweled on my phone (an horribly addictive game on painkillers), I got to thinking about the experience of pain and the limits of language. We know of a rather large number of experiences that are incommunicable, love and ecstasy among them. Love inspires all kinds of words (I can write long letter after letter in swoon), and spiritual experience, much of the same. These ineffable affects also motivate all kinds of positive behaviors. Pain, on the other hand, invokes one conscious desire and narrows the need for expression to one simple demand: make it go away. Or, to pull all the powerful affective experiences of life into one well-worn phrase, "Oh, for the love of god, please make it go away!"

Because what ties together most of my intellectual interests today is, more or less, the experience of the ineffable and our attempts to talk about that experience, I have predictably started thinking about "the rhetoric of pain" as a future avenue of research. I started my academic career writing and teaching about the experience and uses of popular music; for me, the "rhetoric of music" concerns the ways in which folks speak and write about the musical experience (that, in fact, is the topic of the third book I plan to write). Currently I'm working on a manuscript about cultural or collective mourning and the role of human speech in that process, and I've recently written about talk about "love," whatever that is. Pain, however, confounds a lot of my assumptions about ineffable experience, the key among them: that we want to talk about, that we want to share our experiences of the ineffable in the proximity of its immediacy. In pain, sharing is not as much of a deep desire---one just wants it to stop. Maybe we want to talk about it later (like I am now, with the pain held at bay), but in the strange, elongated experience of pain, sharing is not the secondary impulse.

Of course, I don't mean psychological pain (mourning, depression, anguish, regret, hurt, and so on). I mean here physiological pain. I realize, when you push the concept, distinguishing between the physiological and psychical is not so easy (and, in a sense, one of the founding challenges of psychoanalysis)---and in one's conscious life the two are often conflated. Thinking pragmatically, however, I do think the distinction is helpful because the validating discourse of medicine lends legitimacy to the physiological and has trouble contending with the psychical, which is where the body butts-up against "culture." The logics of distinction between the two are fundamentally rhetorical themselves, and interesting to think about (for there is where ideology is, more or less, naked for all to see, like the emperor).

I started to think about the rhetoric of pain when I was in the hospital a few years ago with acute pain in my chest. I had a virus that attacked the lining of my heart, and until that point in my life, I had never felt such pain. It was truly breathtaking---debilitating to the point I couldn't breathe with each pang. I remember the nurse pointing to a chart on the wall with happy faces and increasingly sadder faces, asking me which face (or number, from 1-10) best accurately indexed my pain. I thought the request was absurd and, of course, in retrospect I never pointed the most pained face or highest number when I should have. In retrospect, my pain at times was a solid 12 on a 10 point scale, but I said "uh, six?" Why did I say that? What forces were at work to get me to impose a modesty on my physiological experience? What cultural filters were at work, there? What rhetoric of pain was I channeling?

Recently a dear friend had a child, and she hinted at the pain (and her husband's abject terror at seeing her in such pain). There is an experience---childbirth---that is routinely described as the most unbearable pain a (female) human being can experience. And yet, it is literally "the way of the world." Much as been written about that experience, and to some extent the pain of labor, but it's often couched in terms of the tremendous pain endurance of women.

Pain is a very curious and fecund area of rhetorical study, I think, and perhaps one place at which those in the social sciences and those in the humanities might collaborate. Those who work with numbers and those who work with words are faced with the very same impossibility: measuring and describing the experience of pain. So much cultural work has to be conducted at that intersection, the place where the body and language meet-up, in pain.

Fascinating.

I'm gearing up to watch the season finale of American Horror Story tonight, which is rooted in the experience of pain. So much of the show works to suture psychological and physical pain together; Violet, the goth-ish teenager of the show, is a "cutter." The narrative of her cutting has been that the physical pain she imposes on herself concretizes the otherwise ineffable psychical pain she experiences (which would indicated it is not "depression," at least in the clinical sense, but something else). Last week's episode was about the pain of childbirth. For some characters, death is a relief from pain, but for most of the ghosts, death is merely an other-worldly preservative: it not only concretizes pain in material finality, but spiritualizes it to the point that it "haunts" the living (and each other; the television show is interesting because the ghosts are very complex characters). Pain is the place at which the living and the dead come in contact, and the locus at which the living can commune with the dead. (Such a belief, I'm reminded, is central to exorcism; one encounters the demonic via his or her own pain---it's where the demon gets in, and it's where the exorcist encounters the demons of the one s/he's exorcizing, through the exorcist's own pain.)

When you suffer chronic pain, your senses for it in other places---Others' experiences---are heightened. You start to notice the "rhetoric of pain" everywhere, you start to see it as one of the central experiences of life, all these things we do to contemplate pain, and all these things we do to make it go away. It could be argued (as Freud and others have) that the experience of pain is sometimes courted, because there is some pleasure mixed up with it. I would say, however, that this pleasure is "rhetoric" getting in there, somehow, the word lodging between body and its representation. Words create a metaphorical distance; the death of the word---the dead word---is a strange palliative, a version of Plato's pharmakon, if you want.

Is the hydrocodone typing? One wonders. Paging Timothy Leary . . .