We, mammals with few natural defenses (lacking claws, camouflage, and saber teeth) and limited reproductive capability (having few offspring, who take many years to reach maturity), are the most closely guarded by a hypervigilant nervous system and a brain with special capacities for generating pain and turning it into a world of unhappy associations and emotions—of dread, loss, anguish, anxiety, regret, and suffering.
THEIR EYES WERE OPEN TO SUFFERING
A woman whose leg is caught in a crevice would feel pain commensurate with the threat the injury poses to her survival, just as a deer would. But as evening descends, another feeling would begin to set in. Although her brain would release the same neuropeptides that allow the deer to sleep off the pain, the woman would lie awake, contemplating this pain and its implications. What if no one comes to help her? She pictures the life that she had, and already it appears both near and impossibly far, like a garden from which she has been suddenly exiled. Along with fever, the sense of ‘etsev (—a Hebrew word with the various meanings of “hurt, pain, worrisome toil, pang, sorrow, hardship, forsakenness, grief, and affliction”), to which Eve was condemned, sets in. Her eyes are open to suffering.
The multiplicity of meanings of ‘etsev reveals what is human about human pain: the way pain is always steeped in sorrow and other negative emotions (a result of a development, unique to humans, of certain kinds of neural bridges connecting the emotional, cognitive, and sensory parts of the brain).
Why? the woman protests. Of course, she comprehends her situation in the same basic way the deer may (she fell; she was injured; she can’t get up). But we cannot picture a human for whom this explanation would fully suffice, because from ancient times onward, humans have also asked a question of a different sort—one that cannot be answered with reference to the material world, but rather that conjures a hidden world of meaning. The question is “why?” in the peculiar sense of “why me?”
This human why—why is this my story and what story is this?—does not seem to serve any evolutionary function. Yet the question is so universal, appearing across diverse cultures over thousands of years, as to seem genetically coded into the experience of prolonged pain, like inflammation and drowsiness.
Why must I suffer? we ask haplessly, fearing the answer and fearing the absence of an answer. And the longer the pain persists, the more the question presses.
The deer’s stumble hurts her, but only the human falls into ‘etsev.
EVIL, HURTFUL THINGS OF DARKNESS
The same questions would pain a woman who fell in the forest today as a woman four millennia ago. The earliest records of history—the cuneiform tablets of ancient Mesopotamia—reflect the urgency to understand bodily pain: how to parse its spiritual significance and alleviate its physical consequences. If the injured woman were an ancient Babylonian stranded somewhere on the Mesopotamian plain, she would understand her pain and injury in a particular way, and indeed, the frame would not be that different if she were Sumerian, Akkadian, Assyrian, ancient Egyptian, Roman, Greek, or Indian.
If I were that woman, I would know that pain, illness, and death arise from a vast, invisible cosmological contest between the opposing malevolent and beneficent demons and deities that control the natural world and compete for domination over mortals. Hosts of demons could enter the body through the unguarded openings of the eyes, mouth, nostrils, and ears, where they would suck the marrow out of bones, drink blood, and devour organs until—save for the intervention of a benevolent deity—the victim perished. Protection could come only from the gods, who, though unreliable and inattentive, must be petitioned for aid. If I were a Babylonian, I would have a personal god whom I cultivated with prayers and offerings and invocations. “One who has no god, as he walks along the street, Headache envelops him like a garment,” warns a Babylonian fragment.
For the ancient Egyptians, the body was divided into thirty-six parts, each one the province of a particular god or goddess. In some traditions, demons shared their names with the specific maladies they inflicted. The ancient Indians were tormented by Grahi (“she who seizes”)—a she-demon who caused convulsions. For the Akkadians the D’û demon caused headaches. Indeed, D’û was headache—to have a headache was to be possessed by the demon, so there is no other Akkadian word for “headache.” In Babylonian texts, the words for “sin,” “sickness,” and “demon possession” are closely related and often used interchangeably.
How might I rid myself of these demons? In the ancient world, ritual magic could be used to dispossess demons, or pain could be transferred from one person to another. In Babylonia there was a special class of priest, called gala-tur, who could absorb an ailment from a living person and carry it into the netherworld and dispense it there. A suckling pig or kid could be sacrificed, and the demon could be transferred to the animal’s body. In some cases, expelling demons from the body called for graver measures, such as trepanation—drilling holes through the skulls of the sick to release the demons causing migraines as well as seizures and other ills.
While demons, ghosts, and other evil spirits were more common than gods, in most cultures the powers of the gods were superior. So although the gods could not eliminate the demons—who were also immortals—they could control them. I might turn to the Ebers Papyrus, a compendium of ancient Egyptian prescriptions, spells, and enchantments from 1552 B.C.E. that is one of the oldest medical documents in existence, to find an invocation to the gods, imploring them to “free me from all possible evil, hurtful things of darkness.”
I would know, though, that unfortunately, pain and disease could arise directly from the gods themselves. Some gods were consistently adversarial, but most were mercurial and might be swayed by entreaties for assistance and dissuasion from harm. Arrows thrown by Rudra, the ancient Indian Vedic storm god, brought humans sudden pricks of sharp pain. But his hands also contained “a thousand remedies,” and his urine, the sacred element of rain, was an anodyne. The Greek god Apollo shot invisible arrows and spears at men, causing illness and death—sufferers were “Apollo-” or “sun-struck”—while his twin sister, Artemis, afflicted “Artemis-” or “moonstruck” women with female maladies. Yet Apollo was also known as a healer: sacred hymns that pleased him might lull him into ending plagues, while Artemis was also known as a goddess-physician, specializing in obstetrics and gynecology.
If I were a Babylonian, I would implore my personal god to lobby for me in the pantheon of gods, as in this invocation in which Marduk, the patron deity of the city of Babylon, consulted his father, the god Ea, about an innocent human victim: “Oh Father, Headache has set out from the Underworld . . . whatever this man has done, he doesn’t know it; however will he be relieved?”
Comfortingly, the gods themselves were vulnerable to pain and disease and used spells and curses to rid themselves of pain, which mortals could imitate for their own cures. For example, the Egyptian god Horus was tormented by catfish demons that caused him migraines so severe he sometimes resorted to living in the dark. The great sun god Ra (who suffered from eye diseases, which manifested as eclipses) helped Horus by threatening to cut off the catfish demons’ heads with his tmmt-loop, his sacred scepter. If I were suffering from a migraine and I incanted this story while my head was rubbed with a tmmt-loop made of snake, the demons might flee from me as well. Alternatively, the demon could be dispossessed by rubbing my skull with the ashes of the bones of catfish boiled in oil for four consecutive days.
I could read stories of cures of both gods and men on the walls of temples dedicated to the healing gods in ancient Mesopotamia, Egypt, Greece, and Rome. I might even sleep in the temple, undergoing purification rituals of fasting and bathing, and make an offering to the god or his animal representative. During the night, the gods might reciprocate by transmitting cryptic clues for cures in the form of opaque dreams, which would be interpreted by priests in the morning. If I were too ill to travel to the temple, my family or friends might make the pilgrimage on my behalf, as when A
lexander the Great lay dying in Babylon and his generals slept in the temple of Marduk on his behalf. Evening rites often involved the use of opium, which would lull pain and induce vivid dreams for the priests to interpret. If a cure did not arise, I could continue to stay in the temple and further entreat the god. (Dying patients, however, having been scorned by the gods, would be cast out by the priests lest they pollute the temple.)
If I were Greek, I might sleep in the temple of Asclepius, the god of medicine, whose followers—priest-physicians, such as Hippocrates, who claimed to be his descendants—took an oath to heal, to cause no harm, and to keep secret their sacred medical knowledge, a pledge that may be a template for the modern Hippocratic oath. Statues of Asclepius often feature him with his symbol, a serpent-entwined staff that expressed the ancients’ belief in the twinning of divine help and harm—the intimate relationship between poisons and remedies, healers and destroyers. Even today, a version of the serpent-entwined staff survives as a symbol on ambulances and hospitals: an indirect tribute to the god—or plea, perhaps, for his protection—who, in the words of the fifth-century B.C.E. poet Pindar, “first taught pain the writhing wretch to spare.”
Words themselves could become medicine, as in the Egyptian practice of writing down an incantation or spell with edible ink, dissolving the letters in liquid, and then drinking it. But spells and incantations were often paired with natural remedies such as herbs, roots, or the testicles of an exotic animal, with which they worked synergistically. Babylonian tablets dating back to the third millennium B.C.E. detail how each ailment corresponded to a particular deity or demon and required an individual remedy. If I were a Babylonian with a toothache, I would know that it was caused by the sucking of a primal demon-worm. When the worm was first created, a god offered her some nice food to eat, but the worm rejected the food, saying, “What are a ripe fig and an apple to me? / Set me to dwell between teeth and jaw, / That I may suck the blood of the jaw / That I may chew on the bits [of food] stuck in the jaw.” The worm’s request was granted, but she was cursed for her bloodthirstiness. Invoking the curse by reciting the story of the worm’s creation three times over a poultice of beer, oil, and a (now-unidentifiable) plant and applying it to the tooth would cause the toothache to resolve.
As the Egyptian Ebers Papyrus explains, “Magic is effective together with medicine. Medicine is effective together with magic.” Although it would take millennia to understand why, magic is effective together with medicine and medicine is effective together with magic: words (when given the power of belief) do affect pain—and words in combination with physical treatment can alleviate pain in ways better than either treatment alone.
NO GOD CAME TO THE RESCUE, NO GODDESS TOOK PITY ON ME
But sometimes all remedies failed. As civilizations developed, anthropologists have observed, the gods tended to grow in power while the demons’ status diminished. Over the course of the ancient Mesopotamian empire, for example, as the Sumerians gave way to the Babylonians and Assyrians, it was increasingly believed that demons could only act as permitted by the gods—or as enabled by their absence or indifference. Thus pain and illness raised the haunting question of why the gods were failing to intervene. A Babylonian monologue from the fourteenth century B.C.E. known as the Poem of the Righteous Sufferer concerns the plight of a nobleman who is inexplicably cursed with misfortune, pain, and illness.
My own god threw me over and disappeared,
My goddess broke rank and vanished.
The benevolent angel who [walked] beside me split off
My protecting spirit retreated, to seek out someone else . . .
I called to my god, he did not show his face
I prayed to my goddess, she did not raise her head.
The nobleman details his faithful efforts to conciliate the gods. Despite his piousness:
Debilitating disease is let loose upon me . . .
Head pain has surged up upon me from the breast of hell,
A malignant specter has come forth from its hidden depth . . .
A demon has clothed himself in my body for a garment . . .
My flesh was a shackle, my arms being useless . . .
A crop lacerated me, cruel with thorns
No god came to the rescue, nor lent me a hand
No goddess took pity on me, nor went at my side
My grave was open, my funeral goods ready . . .
At the poem’s conclusion, the sufferer has a dream in which the god Marduk belatedly heals him:
My illness was quickly over, [my fetters] were broken . . .
He bore off [the head pain] to the breast of hell,
[He sent] down the malignant specter to its hidden depth,
The relentless ghost he returned [to] its dwelling.
Yet it is the anguish of the abandonment that lingers. Why do the gods desert us?
Pain Diary:
I Avoid Diagnosis
Confronted with the mystery of physical pain, “willingly or unwillingly, we enter a realm that is somehow set apart,” David B. Morris writes in The Culture of Pain. “We might even say it is the most earnest wish of almost every patient, ancient or modern, to be released not just from pain, but from the requirement of dwelling within its mysteries.”
I did not wish to dwell in a mystery. I wanted to live in my old life and my old body, just as I always had.
PAIN HISTORY: Describe your symptoms and their progression. How did you treat it? What aggravated your pain; what ameliorated it?
The morning after Kurt and I first spent the night together, I took the train back to New York City, and Pain came with me. This came as a great surprise, though I realized unhappily that there should be nothing to be surprised about. Pain was there on the train, and there in the taxi from the train, and there as I told the doorman I had a good trip and opened the door to my apartment world.
Everything was just as I liked and had left it: my smoky blue Siamese perched on the velvet sofa I had matched to her coat, my Depression-era teapot collection lined up in optimistic pastels on the window ledge overlooking the courtyard. I settled into an armchair to read my mail, but the chair no longer fit my body. It was impossible to get comfortable with Pain sitting there, too. I rose, and Pain rose with me.
A terrible thought occurred. What if Pain were planning to stay? What if I were never again free to read, because I’d always be reading with Pain? What if I never slept, because I was sleeping with Pain?
I decided to go out to buy Tylenol. The ordinariness of the errand—going to the corner drugstore as if I simply had cramps—was soothing, though the pills made no difference.
“Throughout life I have seldom known respite from pain, having had at least two hundred days of suffering each year,” Nietzsche writes. In his final stage of syphilis, consumed by burning nerve pain, he declares, “I have given a name to my pain and call it ‘dog.’ It is just as faithful, just as obtrusive and shameless, just as entertaining, just as clever as any other dog—and I can scold it and vent my bad mood on it, as others do with dogs, servants and wives.”
I had always liked this saying. I had copied it down in a notebook upon first reading it. Yet the image struck me as fatuous now—I didn’t believe even Nietzsche truly felt that way. Was he trying to cheer himself up by pretending he was master? Was he not in pain when he wrote it? Was he kidding?
Pain began to establish dominion in my world. Pain was not like a violent intruder who batters his way in, wreaks havoc, and departs. It was more like a sour domestic partner—intimate and ugly; a threatening, dirtying, distracting presence, yet one who refused to move out. I did not like waking up to feel its grubby hands on me; I did not like it hanging about in the kitchen, making me drop heavy dishes; I did not like it interrupting my phone calls, especially when a friend was confiding a sorrow I cared to hear. I cared, but not the way I used to care, because part of me now cared only about Pain.
My neck hurts, I checked myself from interjecting, plaintively
, while my friends discussed their marriages and miscarriages. My arm hurts, too. It sounded like a little kid’s complaint: I have sand in my shoe.
Pain: it seemed like such a trivial kind of problem to have, categorically different from the deep, meaningful problems with which I liked to think I was preoccupied. It offered nothing to think about, no psychological or spiritual tangle you might unravel in a long, satisfying conversation with a friend while walking around the reservoir in Central Park or drinking tea in a favorite café.
“Pain, while always new to you, quickly becomes repetitive and banal to your intimates,” Daudet observes. But I was not only afraid of boring others, I was bored with pain myself—bored to tears. I had never had a problem so utterly consuming and so intellectually empty.
How did I get pain? I didn’t seem to have an injury. Several times a day I found myself peering into a mirror, but there was never anything to see. I had endless variants of dreams where I was being hurt—stabbed or twisted or burned—from which I would wake to realize that I had moved the wrong way in my sleep and my sleeping brain was trying to understand the pain, to give it a narrative.
I’d wake, shaking off the foggy images, reminding myself of all that I was not. I was not sleeping in a temple to Asclepius, waking to find the clues to my cure contained in a dream. I was not a Babylonian fettered by pain and no god came to the rescue and no goddess took pity on me; nor was I a Ghanaian man I had read about in a newspaper who was hung by an arm for days and even now, years later in a torture treatment program in Michigan, still weeps to recall it. I was a woman in real silk pajamas lying on a king-size Tempur-Pedic mattress under a white Shabby Chic comforter in a room with a really decent view. In Manhattan.
The Pain Chronicles Page 4