Magazine article The Christian Century

Pain by Number

Magazine article The Christian Century

Pain by Number

Article excerpt

THE FIRST TIME I saw an orthopedist about my bum hip, the nurse pointed to a row of smiley faces on the wall--six of them, with numbers and short phrases underneath. "What number is your pain?" she asked, waiting as I scrutinized the scale. Face One looked like a toddler on a swing ("Doesn't hurt at all"), but Face Two had lost her innocence ("Hurts a little"). Face Four looked as if she had a toothache ("Hurts even more"), while Face Five's smile had turned upside down ("Hurts a whole lot"). Face Six had tears running down her face ("Hurts all the time"). She looked as if a horse was standing on her foot.

This was not much to go on--the smiley face equivalent of a Rorschach test--but I did the best I could. My hip hurt all the time, thanks to a mild case of dysplasia I had hiked, biked and run with all my life. Now the cartilage was gone so that even sleeping hurt. I looked at the scale again. I definitely was not on the smiling end of the scale.

The nurse glanced at her watch, twirling her pen between her fingers.

"Five, I guess," I said. "Sometimes six, but mostly five." She recorded my answer, asked a few more questions and took me to the X-ray room.

Twenty minutes later the doctor snapped my films onto the light board, tapped the bald head of my right femur and said, "It's not a matter of whether you have surgery but when--and trust me, you'll know when." While this was not happy news, it made me feel better about the smiley face test. At least the pain was real.

Less than a year later, I woke up in a hospital room with a new hip. Three times every day, the nurse pointed to the smiley face scale on the wall at the foot of my bed and asked, "What number is your pain?" Well, let me see. I have an eight-inch incision in my leg, the head of my femur has been sawed off and a metal spike has been hammered into the hollow of the bone.

"Five," I said every time. "Six when the physical therapist is here, but mostly five." This might have been my answer even if I had not been allergic to the pain medicine prescribed for me, but since I was getting by on Extra Strength Tylenol I felt completely justified. If six was as high as the scale went, then six was what I wanted.

Within the week I was back home with the physical therapist assigned to help me to my feet. …

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