Chronicling Chronic Pain Marley Richmond
“So we beat on, boats against the current, borne back ceaselessly into the past.” —F. Scott Fitzgerald, The Great Gatsby
I don’t remember exactly when the headaches started, only that at some point when I was seventeen, my head began to hurt and did not stop. I didn’t notice my ship was leaking until I was up to my neck in water, and untold days passed once I was pulled into the riptide. In the nervous system’s pain response, “first pain” is most acute, followed by a duller “second pain,” an echo caused by slower signals. Every single day, I was awash in echoes; everything triggered my body’s alarm—my laptop’s screen, a printed page, any amount of light, my best friend’s voice, a change in position, a touch, all threatened to drag me further under the current. I forgot how to hope for a pain-free tomorrow. After six doctors’ appointments and a nine-month headache, I still only found a partial diagnosis—a what without a why, but nevertheless, an elusive lifeboat on the sea of chronic pain. “True (primary) chronic daily headaches don't have an identifiable underlying cause,” states Mayo Clinic’s headache information. The page offers this fact calmly, without qualification, although the sentence has broken me as many times as I have read it. In instances of acute pain, the response can be almost immediate. Pain becomes chronic when the nerve response system 80
continues to fire, even after the cause of pain has been removed. Without a detectable pain stimulus, chronic pain is often difficult to treat. Therefore, because true chronic daily headaches may not have an identifiable underlying cause—first pain— they may be impossible to treat—second pain. In the early months, I sought pain stimuli where there were none, looking for something to fix. The first specialist I saw was an otolaryngologist, who approached my headaches as a problem with my jaw. Of this appointment, my doctor wrote, “She is in acute distress, although she is just a bit tearful today.” A generous assessment—I had burst into tears the moment I sat down in the office—but also an apt description of all my headache-filled days. Those tears were a record of the storm beating inside my head. I tried again in ophthalmology, searching for a new form of modulation that might cause a ceasefire in my nervous system. I’d never worn glasses before, nor did I have any issues with my sight. Alas, the shoreline—and problem—evaded me still. I saw my regular pediatric doctor as well. By this time, I could’ve listed the nurse’s questions before she asked them. Six months into the never-ending headache, I could recite my sleep schedule,
