Pain

Imagine for a moment, if, upon waking each morning, you are soundly beaten by a stranger with a baseball bat. You call police to have your assailant arrested, only to be quizzed by the dispatcher in a patient voice, asked to describe the bat, and to rate the assailant on a scale between not being assaulted, and the worst attack you've ever suffered. You are asked to describe these things in terms that are completely unrelated to the attack, such as artistic comparisons, or mathematics, and all while the beating continues uninterrupted. The person you are talking to treats you as if you are stupid, lying, or intoxicated because the beating makes it hard for you to concentrate and communicate.

You end up having to beg the police to stop the stranger from beating you... being treated as if you are weak because you begged, or even just because you don't want to be beaten by the stranger with the bat. No matter what you say, they won't listen, but instead tell you that lots of people are assaulted by strangers with baseball bats each morning, as if knowing that you are not the only one will somehow make the beatings more tolerable.

After going through all of this, you are told that you've reached your limit of assailant arrests, that you've been helped by the State police, the FBI, and the Marines, and you can't be helped any more. You know it's true, because they're still all there, but they're outside defending you from other assailants. You've just called for reinforcements because this one got through.

Perhaps you have become a nuisance to the dispatcher. Perhaps she just doesn't know a nice way to tell you that she cannot help you. Either way, she sends you packing. She tells you that you'll have to learn to live with your assailant. You are treated as a criminal for seeking help, with sidelong looks given, and clucking of tongues, to make you feel dirty and low. The evidence your assailant is right there in the room with you, beating you as you speak to the dispatcher, is unimportant. You're obviously an attention whore. Your assailant is probably all in your head. You made your assailant up because you have a thing for cops.

After calling and calling, searching for any kind of help, you finally find someone who understands your suffering, a dispatcher from a unit that specializes in countering consistent patterns of assault... but he tells you his hands are tied by federal laws regulating his work, which do not differentiate between a stubbed toe and an assailant with a baseball bat when it's one who has gotten past your other defense force. Since you wouldn't need police to control a stubbed toe, you can't have protection from this guy with the bat. This dispatcher, too, admits he can do nothing to protect you from this particular assault, but he says he can give you something to make you less depressed about being beaten. Desperate for relief, you accept the somewhat comforting service of an emotional therapist. Your therapist can't help you get rid of the assailant with the bat, but he can help you process the sense of hopelessness and despair that results from being beaten all day long. 

When others find out what you've been given, you discover the stigma of mental illness as they treat you like a crazy person. They gossip, warning each other to be careful around you because your behavior might be unpredictable. Parents of your children's friends deem you the untrusted parent, the one who might feed the kids dessert for supper or say the wrong kind of things in front of them. Dear god, what if the kids are at your house when you have a breakdown? After all, you need a therapist to get through everyday life! Every assumption seems reasonable while ignoring the stranger beside you, still bashing that bat into your body. Who needs context when it's easier to be judgemental?

You lose your job, because trying to work around that stranger interferes with your performance until you become completely ineffective. Then, you are treated like a deadbeat because you cannot work, others telling you about times when they've been kicked in the leg once or punched in the jaw, and still were able to work, so why can't you? What's wrong with you? Why can't you just man up and work through this situation? If your assailant is not hitting you in the head, why can't you just change to a desk job, where his behavior won't prevent you from doing the work? Nobody considers that being constantly pummeled with a bat might not only impair your ability to do manual labor, but to exercise the focus needed to perform mental tasks, as well. Nobody considers the fact that they're comparing unlike circumstances and temporary incidents to a long-term situation. They simply see an able-bodied man without a job.

Maybe you just happen to be somewhere public when your assailant slams the bat into your gut... then you find out the building's restroom isn't public. Describing your situation does not elicit sympathy from whoever controls access to that restroom. No, you've got a problem, one they don't know can't rub off on everyone else who uses that same facility. And the fact that you're followed around by all those cops - clearly you're the wrong type of person to be in this building. Are you just going in there so you can call for more?

Worse, any appearance of desperation you might have because of your situation will be treated as aggression. Clearly you're just an impatient, overprivileged jerk who feels entitled to exemption from the rules that apply to everyone else. You're standing there demanding special treatment, for no obvious reason.

You are treated as too rude, too dirty, or too dangerous to use the bathroom, as the stranger stands there, unnoticed, continuing to hit you with the bat. You rush, humiliated, to the nearest place that you know does have a public restroom. You just hope you make it in time.

At the grocery on a bad assailant day, you have to use your handicap tag, park in the wheelchair space, and use one of the electric carts, because your assailant has hit you so hard in the back, legs, knees, or hips that you cannot walk in the cold, or cannot walk all over the store. The other shoppers look at you as you walk from your car in the handicapped space to the electric cart, sit down, and begin driving it.

Imagine the lack of understanding, the judgmental head shakes, stares, and sometimes even cruel statements made. Maybe you wouldn't need that cart if you weren't so fat. You should walk around the store for exercise. When they don't have the guts to say it to your face, you get to hear them talking behind your back. He doesn't need that cart. He didn't need it last month. He's just lazy. Shame... he should leave it for someone with an actual handicap. Security should kick him out for using it.
Shame. Tsk-tsk.

Even the people who know you and know you're under constant assault don't really understand. They were sympathetic at first, but eventually they tune out your assailant, even though you cannot. You can tell by their actions, and their reactions. They ask you stupid questions, such as "Why can't you just suck-it-up-and-drive-on?" or "Why does everything you do take so long?" and "Why don't you just call the police?" If you remain silent about your problem, people forget it's happening, but if you speak up, regardless of how much your assailant hits you, you're a buzzkill and everyone will avoid you. You have learned to walk a fine line between mentioning your limits when you have to, and keeping your mouth shut when you don't.

This is compounded by the fact that some of those who know the size of your existing defense force don't believe this assailant is real, and some of them suspect there are less to defend against than would merit the force you've employed. Some treat you as a person impaired in ways you are not, on the assumption that the noise from the fighting prevents you from thinking properly. Others blame any random problem which occurs in your life on your defense force, and advise you to get rid of them. Still others, pursued by different types of attackers than the ones after you, recommend you try their defenders. "I know what you're going through. I'm being attacked by sea. You should quit with the Marines and try out the Navy. The Navy is working great for me!" Often, people who make suggestions get offended if you don't run right off to try them out, even if you explain that you've already done so to little effect. You're not being attacked by sea. You're being attacked by individuals with baseball bats, and a lot of evaluation went into determining that the best defense force for you was the combination you're using... but none of that matters when there's an amateur dispatcher's opinion to consider.

You know that people's frustration with your refusal to switch methods at the drop of a hint is partly caused by needing to have some way of trying to help, and feeling stymied by that refusal... but it doesn't make the resulting criticism they launch at you... you're just wallowing in it... you don't want to get better... you just want sympathy... any easier to hear.

You're not allowed to fight back on your own, either, and you can't hire a bodyguard. Defense against assault is a controlled action, and must be carefully monitored by proper authorities. If you attempt to defend yourself, and are caught doing so, you will be arrested and jailed for attacking your assailant. All defense will be taken away from you, and previous assailants will be let into your cell, to all beat on you at once. You live in fear that this will happen to you anyway, as you are required to periodically renew your protection (via the feds and the marines) from those assailants.

Unfortunately, you cannot keep the same people involved with your case forever in order to keep your defense consistent, as the type of people who deal with cases like yours are frequently targeted for investigation by the Defense Establishment Authority. Their documentation makes them much easier to target than street assailants, and too often they end up getting jailed for unlawful management of defense forces, leaving you to search for a new resource for help. Each time a new person becomes involved with your case, he or she looks over your history and tells you that you are too protected, and that some of that protection must be removed so that you will be safer. When this does not make sense to you, the new person gives you that same sidelong-look and clicking tongue treatment you've had before, and orders changes to your guard. When the changes reduce the guard's effectiveness, letting through more assailants, and the new person must grudgingly admit things were right before, you are blamed, treated as a weakling, or otherwise made to feel that your need to be protected from harm is invalid. The same old "thing for cops" accusation keeps getting repeated everywhere you go. Evidence that you're actually under constant attack does not matter. The inconvenience you represent to the system is all that does. Your dispatcher is being watched. Working in his field is a crap shoot. At any time, he may become the Defense Establishment Authority's next target.

Each time this happens, in addition to the sadness you experience for your dispatcher, your guilt over having been one of his charges, and the frustration of having to seek help elsewhere, you face a very real fear. If this happens too often, you can get accused of "shopping" for a dispatcher more willing to wrongfully send forces to protect you, and jailed yourself, despite being able to prove your previous dispatchers were no longer available to help you because of their arrests. In fact, their arrests may even be used against you. Obviously, that's just part of your protection seeking pattern.

Talking about this situation to other people once again elicits the shaming response that you must have a thing for cops or attention. Why else, the people ignoring your assailants wonder, would you be so worried? What are you, some kind of defense fanatic?

Though the situation is hopeless, you have no choice but to continue on like this. You cannot fight the authorities who control your access to protection from assault, and there is nothing you can do yourself to get rid of your assailant. You know that for the rest of your life, there will be varying degrees of this type of assault heading your way, and it is up to you to weather them as best you can, taking what help you can get, and living one day at a time. You'd square your shoulders and set your jaw against this tide, but that, too, would just draw negative attention.
You decide to just keep your head down, instead.

Congratulations. You've just had a taste of chronic pain, complicated by breakthrough pain, in today's legal and medical environment.
Hundreds of men and women experience this as they age. Workers in heavy labor industries and dangerous jobs, more likely to be men, will face it at a higher rate than the general population due to work related injuries.

There is a degree of sympathy for women with chronic pain, although it is limited. There's less of a degree when that assailant is attacking a man, and the younger the victim, the more likely people are to treat him like a liar, a layabout, or a lunatic. People are more likely to avoid him than check on him or include him in social activities, often out of discomfort with his situation and their inability to make a perceivable difference in it.

There are, in fact, differences you can make. They're not always the ones you're looking for.
The chronic pain sufferer in your life knows you can't get rid of his pain. He knows you can't pay his bills, or become his caregiver. Those things are too big for one individual to help with. Don't let discomfort with your inability to fix everything become a reason for you to contribute to his isolation, when that is the one thing you do have the power to affect.

Keep in contact, even if all you guys do is send each other memes. Check in on him when you're able. Don't let the time in between days you're able to do that embarrass you. He knows you work and you have a family. There's no law that says you can't visit again because you missed some invisible deadline.

Don't feel like you have to be upbeat all the time, or make him upbeat. Your life isn't all shits and giggles. Don't expect his to be, either.

"It hurts" is a reality. It's his reality. Sometimes just having someone else know makes it more bearable, even if you don't have some profound words of wisdom to make it so. Believe it or not, "That sucks, man. I wish there was something I could do..." can be profound enough.

Does he make gallows jokes about his condition? Let him. Laugh with him, or groan if it's a groaner of a bad joke. Gallows humor is a way of processing experiences that would otherwise be emotionally crippling. Just having a loved one understand that can be an immeasurable relief. Listening without judgement can make a huge difference. It may be frustratingly invisible... but so is chronic pain.

Once in a while, there will be something measurable you can do, like being the driver for a grocery trip because going alone is rough, or spending a couple of hours playing video games with him because that distracts him from his situation, or sitting with him while he deals with the social security administration because those bureaucrats will run him over if he doesn't have a friend there to witness their behavior... or writing a short letter to a pain clinic describing the person you know him to be so he doesn't get treated like an addict when his arthritis kicks up a notch in cold weather... or getting him go to a sports bar with you when depression about his condition has been keeping him home. Essentially, be a friend to your friend, the same as you would any of your other friends.

Got extra nervous energy to deal with because of the situation? Yes, it is hard to see someone living under an adverse condition you can't protect him from or remove from his life. It's not wrong for you to get frustrated, angry, worried, or just antsy with the need to do something about the problem.
So you can't get rid of his pain. So you can't be his doctor, his housekeeper, his nurse, and you feel like sitting around his house playing video games or watching TV, or even including him in your outings isn't enough. That's not wrong. That's fuel for activism.

One of the big problems faced by chronic pain sufferers, at least in the U.S., is that our government has decided to lump them in with street drug addicts. More and more limitations are being placed on what types of treatments are available to them. Their access to pain control medication is being reduced, while at the same time, their insurance providers are allowed to deem pain control therapies like massage and other physical therapies unnecessary. Then they're told, based on data from when people had better access to pain care, that their conditions are not disabling. And maybe they wouldn't be, if they were receiving proper treatment.

Politicians need to hear that this is stupid. While it's reasonable for medical professionals to monitor patients' pain care to avoid addiction and medical emergencies that drugs can cause, using the drug enforcement agency to monitor that has resulted in the opposite. The shrinking resources for chronic pain patients end up so overburdened that patients who aren't savvy or mindful enough to monitor themselves fall through the cracks. Some end up without access to care, leading to other health problems such as depression, anxiety, and stress... which in turn, over time, can lead to more threatening conditions. Some of those underserved patients turn to street drugs, which are plentiful and easier to get one's hands on, thanks to the DEA's redirection of its focus onto pain clinics, oncologists, neurologists, osteopaths, and other physicians whose specialties mean they're going to have more chronic pain patients than the average general practitioner. Exactly how does that protect people from drug addiction?

You don't have to break your friend's confidence, or draw any attention to him in particular to explain this. Just make the point that medical treatment is best assessed and administrated by medical professionals. It's good when the DEA polices things like drug diversion (medicines being stolen.) It's bad when, based strictly on a set of numbers, they arrest oncologists for providing pain relief to dying cancer patients, or pain specialists for helping degenerative disk disease sufferers manage their symptoms well enough to continue to work. This is something you can affect with minimal effort, just by sending an email or a fax to your state's representatives telling them why, in your experience, the federal government's overzealous interference with pain care is more harmful than helpful. Enough people doing this will show federal representatives that public opinion is set against the policies that make your loved one's life more painful. That's a big chance to do something about the problem.