Rate Your Pain

NONFICTION

By Emily Tyler Kauffman

When I was a child, I was convinced I had a brain tumor. I was prone to headaches, and I always felt them in the same spot behind my left ear. Once, at a neighbor’s house, I drank a V8 with mango in it and my mouth felt swollen and itchy. I told my mother about my brain tumor and my aching tongue and she told me I was a hypochondriac.

“What’s a hypochondriac?” I asked.

“Someone who thinks they’re sick when they’re not,” she told me.

My headaches continued and as I entered my teenage years they morphed into chronic migraines that were soothed or exacerbated as the cocktail of antidepressants and antianxiety meds I was taking was tweaked and retweaked. I still harbored a secret fear of brain tumors and aneurysms, but I learned to keep my thoughts to myself. Everyone around me thought my brain was broken enough.

A new fear took root: ovarian cancer. The silent killer of women. I bled so much each month and the pain was so bad that I was prone to fainting and nausea clawed my throat. I was supposed to hurt during those five days, though; it was in the in-between when I felt aches and stabs in my lower belly that I began to worry that my body was attacking itself. I pressed my hands against my pelvis and considered cancer, eventual

infertility, and early death.

Once, when I was sixteen I was having sex with my boyfriend and the pain was so huge that I began to cry. He froze over me, frantic.

“It’s okay,” I told him, “keep going. I’m fine.”

“You’re not fine,” he said.

He heaved himself off me, dressed me in oversized clothes, and tugged me into the kitchen where he fed me chocolate chip cookie dough and convinced me to call my OBGYN and schedule an appointment. I had an ovarian cyst the size of a tangerine on my right ovary. My doctor prescribed me birth control in the hope it would shrink and prevent more from growing. I felt vindicated: my pain recognized as real and valid.

A few years later when every inch of skin from my chin to my toes was covered in hives, I dragged myself to the university’s Student Health Center where the nurse informed me that I had a mango allergy - she didn’t need to test me because apparently mango allergies result in a specific hive pattern, the one inflamed on my body. I called my mother as I waited for my antihistamines, “I told you!” I said, barely suppressing the urge to scratch and gloat. My mother laughed and my fingers flexed.

Growing up was a haze of doctor’s appointments: stomach ulcers, cortisone shots in my knees, lesions on my liver. Somehow, these things always made me feel guilty, like it was my fault my body hurt or my fault for complaining that it did. Even when the cause of pain was identified, so much time would have passed and I’d have to explain myself to so many people that there was no longer any sense of satisfaction in diagnosis. Any time a physician spied the list of antidepressants I was taking, my pain was attributed to my mental health and pushing to find a reason beyond that, a physical source of hurt, became an

exercise in exhaustion.

I began to avoid going to the doctor all together. They scrutinize you, weigh you, judge you, reduce your life to scaled items in an attempt to make your pain tangible. I learned to suffer silently, that my pain would either go away with enough sleep or I would learn how to work around it. I developed a routine for my migraines, saved up my sick days at work for stretches of pelvic pain or crushing fatigue and dizziness.

This is the constant: I am never sure if my pain is real because I have been made to believe that I cannot trust my body. The migraines, the throbbing in my liver, the stabbing pain in my pelvis that leads to body sweats, puking, and fainting spells. All these things fall under the verbal umbrella I don’t feel well. I don’t elaborate because elaborating feels like justifying, feels like I’m trying to prove something that is impossible to prove because I am the only one who resides within my skin and even I am not sure sometimes if I am sick or if this is just what it feels like to be alive.

One recent Sunday I woke up in pain: a tunnel of throbbing heat in my lower right belly that radiated to my lower back and down my right thigh. I whimpered. I crawled. I buried myself beneath quilts on the couch. I couldn’t eat, could barely stay conscious. Sitting was excruciating, standing impossible. The pain reminded me of the ovarian cyst I’d had in high school, but unlike then it didn’t ebb and flow, it was relentless.

Sunday bled into Monday. On Tuesday I forced down the nausea and dragged myself into work. I hyperventilated in the car and cried at my desk. I couldn’t think around the pain. My coworkers convinced me to go to the ER where I spent seven hours sweating on plastic seats, having my blood drawn, and lying beneath heated blankets in the CT. Curled on my side

on a bed in the hallway, I listened to a doctor tell me there was nothing wrong. Go home, she said. Alternate ibuprofen and tylenol until I felt better or worse. Next time, she said, don’t wait so long to come in if you’re in so much pain. I wondered about her logic - I came in and they told me there was no reason for me to be hurting.

I stayed on the couch on Wednesday, but forced myself back into the office on Thursday. I had run out of sick leave and couldn’t afford to miss more work.

“Fair warning, I might need to randomly lie down,” I told my coworkers, lifting the bundle of sheets I had tucked under my arm. “Sitting hurts too much.”

“Why are you here?” they asked.

“They said there’s nothing wrong,” I said.

I lasted until lunchtime before the tears came back. I laid on the ground, but when I tried to stand, I couldn’t. I covered my face with my arms, drew my knees to my chest, tried to breathe around the pain, tried to convince myself it was in my head. Mind over matter, Emily, my mother always used to say, mind over matter. My boss found me curled behind the desk.

“I’m calling an ambulance,” he said.

“No! I can’t afford that!”

“I’ll drive her to the ER,” another coworker volunteered.

“I just want to go home,” I said.

“Ambulance or she drives you,” my boss replied.

“Do you even have anyone at home?”

They knew I didn’t.

“Fine, but not Fairfax. I’m not going back there.”

There was a smaller ER nearby, part of a healthplex that provided emergency care but couldn’t conduct surgeries like the Level 1 Trauma Center I’d gone to two days before. The nurse

assigned to me was kind and funny and stayed by my side almost the entire time. A simple ultrasound later they diagnosed my problem: a hemorrhagic ovarian cyst. They provided me with pain medication, told me it would resolve on its own eventually, urged me to follow up with my OBGYN as soon as possible.

“I told them the other day that it felt like an ovarian cyst,” I said. “I told them that.”

The nurse shook his head. “I don’t know why they didn’t do an ultrasound in the first place,” he replied.

The earliest available appointment my OBGYN had was two weeks later. I sat in another plastic chair, blood-pressure cuff squeezing my arm, and watched another nurse confer with my doctor over my ultrasound results. They talked as if I wasn’t sitting three feet away. The nurse moved me to a private room, and I listened to the crinkle of paper beneath my shifting body as I waited for my doctor to come back to the room to speak to me.

“You didn’t need to come in,” she said. “Women in childbearing years get cysts.”

I told her I’d had one before, even though I’d been under her care then too so she should have known that. I told her I’d recognized the pain but that it had been more intense.

“I couldn’t focus or eat or anything. It was so much worse than last time, so, you know, I just wanted to check in and see what you thought. They told me in the ER to follow up with you.”

“Well, it hurt because you were bleeding into your abdomen. You’ll probably get them again, it’s just something that women deal with.”

At home I cried. Don’t wait so long to come in next time, one doctor had said. You didn’t need to come in, said the other. It’s just something women deal with. Did I have a low pain threshold? I

didn’t think so. I’d gone through labor, sliced my thumb almost to the bone while chopping vegetables, gouged my arm on glass, accidentally branded my wrist while carelessly frying churros. There were the migraines, the torn meniscus, the stomach ulcers, the scar tissue from my Caesarian Section. I’d dislocated my shoulder ten times. I was familiar with the varied textures of pain. But I was also familiar with no one believing me.

I sat on the couch and I wondered if it was because I was a woman. Because I was overweight. Because I had a history of depression and anxiety. But this is what the world does: it makes you doubt your pain, question your reality, lose faith in yourself. It isolates you from others and from yourself. Then it admonishes you when your sickness overwhelms you; the world wants to know why you didn’t just say something because in a broken system the fault is always your own.