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A Life Larger than Pain

The Pathway from Resignation to Renewal

by Erv Hinds, M.D. (more about this book and author)

Chapter 8: A Life Larger than Pain
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This is the great challenge of pain: Will you allow it to debilitate you or will you see it as a catalyst to delve deeper into yourself and your beliefs? Will you allow the emotions to distort your inner sense of the truth, or will you recognize pain as a crucible from which you will emerge stronger than ever?

–MENACHEM MENDEL SCHNEERSON[67]

WHEN I AM DRIVING back and forth between our pain centers in Santa Fe and Albuquerque, forced to keep moving at a rapid pace while maintaining a constant pitch of high intensity, cell phone in hand, call-waiting in effect, fax machines humming at both offices, computer ready for the next session, six different phone numbers where I can be reached, and my schedule crammed beyond available time slots, I am often struck by the ironies embedded in this geographical cluster of different cultures. I think of the Native American sitting on the mesa, watching nature unfold. I see the Tibetan Buddhist sitting in his meditation, allowing life to teach him fundamental lessons. I picture my friend who is a nun at Christ in the Desert Monastery, quiet and reflective in prayer, laboring to help others by taking away their pain and refusing to flee from her own.

For me, the process of being still, of endeavoring to find the rhythm and flow of life, is at loggerheads with the life I must maintain for too many hours of the day. It is very difficult to transition from the zone of high-performance intensity and sophisticated technology to the realm of meditation and prayer. Those who have structured their routines to

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accommodate the rhythms of the inner life are better prepared for dealing with setbacks and reversals than those who manipulate every last detail of their lives to make sure they waste neither time nor opportunity.

How can we cultivate a sense of wholeness when the demands of life seem to fragment our time and attention? How is it possible for a person to feel whole again when she has irretrievably lost an essential part of herself to injury or illness?

My open-heart surgery in France was a major life event. While my physical heart was undergoing repair, my spirit was undergoing renewal. The wonder of healing is that it has less to do with the mechanics of the body than with the wisdom of the spirit. I now approach my appointments with patients as two-way exchanges, expecting to listen as much as talk. I know that our best work together will be done on a heart-to-heart level.

It is commonly assumed that healing means restoration to the state of health prior to the onset of trauma. Some are fortunate enough to experience a complete recovery from injury or illness. Most are not. I want to affirm, emphatically, that it is possible to live a whole life despite the persistence of physical limitations and frailties. Whatever the body may have lost, the sense of integration acquired through struggle can bind together the ragged and unfinished pieces of our lives in a renewal of meaning and purpose.

The process of quietly finding a way forward through difficult circumstances will often lead to a place in which the heart is at peace. As practical encouragement, I offer the following insights, distilled from years of work my patients and I have done together. These are the lessons of the heart we have learned in the school of pain.

your pain is not your destiny

When pain strikes, you may feel that if it does not get fixed immediately, it will take over your life. But your pain is not your destiny. It is an affliction that will test you and change you, but it need not dictate your future.
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Pain has only as much power over you as you grant it. This lesson has become clear to me especially in the contrast between Anglo and Native American ways of life. I am fortunate to count among my friends a renowned Hopi-Tewa artist named Dan Namingha, who lives near us in Santa Fe.

Dan was raised by his grandfather, a very wise man I was able to meet years ago when Dan was setting the site for his house and studio. I was out on a walk and noticed an elderly man sitting on the hill near our home. As I walked close to him, I could see he was a traditional Hopi Indian. Although he was blind, he sensed my approach. He greeted me and held my hands with his own–old, arthritic, and beautiful–chatting with me in halting English. As I felt enveloped by his deep tender voice and gentle way, our friendship with the Namingha family began.

Dan speaks slowly, with a reflective manner rare in our fast-paced Western culture. He has a patient way of being in the world, a quality of calmness and quietness markedly absent of the ego-driven need to talk loudly enough to ensure that he is heard. I find that hearing what Dan has to say requires careful listening, because he speaks softly with a hypnotic and soothing cadence that lulls me into its rhythms.

Our fear of pain can so preoccupy us that it overwhelms everything else in life and becomes our defining characteristic. Dan explained to me that the Hopi understanding of pain places it on a continuum in the flow of everyday life, an inevitable part of existence. Every day is a healing process. When he arises, he must be joyful and optimistic, always aware of his closeness to the earth and his relationship with all of nature.

Westerners tend to compartmentalize spirituality as one of many dimensions in life, separating it out as a category of life-enhancing potential. We work on our spiritual life to achieve inner well-being in the same way that we go to the health club to achieve physical fitness, or take adult education classes to sharpen mental fitness. This separation is unnatural for the Hopi, according to Dan. Hopis are more likely to say, "I continue to grow and to flow spiritually," in an all-inclusive referral to the totality of their life. Spirituality is integral to the Hopi way of life, from the moment of awakening to every thought and activity throughout the day.
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The Hopi practice of dealing with pain involves becoming immersed in herbal medicines and ceremonies. These rituals divert attention from the physical pain and help promote healing by marginalizing the pain and reaffirming the individual's identity in the unified matrix of life–human, natural, and supernatural. This is a powerful ritual involving a communal ceremony of song and dance performed by sacred Hopi societies to clarify one's place in the universe.

what you think will save you is not your savior

When immediate gratification is a core value, interventions such as surgery, narcotics, and nerve blocks take on an inflated importance. In his discussion of whether to treat disc herniation patients with pain pills, surgery, or both, Dr. Frank Vertosick, Jr. describes the I-want-it-now tendency:

Some people will ask for surgery sooner than others; some people can tolerate pain better than others. I doubt that I would have earned much of a living doing pain surgery in ancient Sparta, but in a community composed largely of type A urban professionals who believe that every shred of their pain should have been gone yesterday, I stay busy.[68]

The very thing you think will save you, however, might possibly be the thing that further entrenches your pain by sending you on an obsessive hunt for an immediate solution. You may find an answer that fulfills its promise temporarily, but you may also be in a circumstance for which no procedure will take the pain away completely. Therefore, the path to a more fulfilling life, away from the limiting constraints of raw pain, leads through many dimensions of the healing process, not just the narrow dimension of pain relief. We tend to be so impatient with anything that derails us from our path toward the good life that we are unwilling or unable to see the opportunities that may be surfacing because of our derailment. Learning to walk the unchosen path requires patience and quiet reflection. It may lead to an opportunity for reclaiming our lost sense of self.
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I will never forget a little old man, physically broken, who climbed up onto the operating table with great difficulty. We wheeled him into the operating room, where I was the presiding anesthesiologist. I had just come from a workout at the gym, and my preoccupation with optimal physical health had me mentally reviewing my schedule for the rest of the day to decide how I could fit in a run. This little man looked up at me with twinkling blue eyes, winked and said, "You know, I'm ninety years old, and I'm not much physically, but every day I grow spiritually." His comment pulled me up short–here I was, the all-knowing doctor standing over his patient, compartmentalizing my life to try and add up to a whole person, when the patient had just let slip a little remark more profound than all my planning and scheming. This wizened little man, on his deathbed for all he knew, had discovered what is most important in life–and even more important, how to build his life upon it.

Healing can teach us that our most important growth takes place within. Yes, we need to honor the gift of the body, but as it ages we need to shift our focus in order to continue growing. As physical growth deteriorates, spiritual growth can accelerate. In some cases, the spiritual growth may be what strengthens physical healing because spirit and body are in better balance.

Acute pain, such as what we feel when recovering from surgery, often has a physiological purpose. In these cases I will tell patients that they are going to participate in a miracle: the process of healing. Millions of cells know exactly what to do in a series of processes far more intricate than the most advanced computer functions. The sensations people will feel after surgery are those of healing, and they should try to reframe them as sensations with a positive purpose–not feelings associated with something bad or something they have done wrong.

This kind of thinking is a change from the voices we are used to hearing, which tell us that pain is punishment, illness implies guilt, physical limitations reduce our capacity for a meaningful life, and aging should be feared and resisted. Turn your dread and fear into expectation, looking for teachers where you least expect them. Your own intuition may be one of your greatest sources of wisdom. Learn to respect it, and you will be able to turn a deaf ear to the false voices that speak the loudest. You

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may well discover the source of your salvation in the wisdom of quiet reflection and spiritual reorientation.

pain can enlarge your life instead of shrink it

Chronic pain can invite us to live a larger life than we had planned. More frequently, however, it leads to a constricted life. Some of this is a patient's choice. The challenge of pain can open up new boundaries, but only if we choose to break the cycle by stepping outside it, doing something different to energize ourselves in defiance of the defeat that pain insinuates.

But change is not easy. "Any significant change in one's life is, in its broadest sense, suffering," writes William J. O'Malley. "Growth itself is suffering, since we have to give up a self we were comfortable with in order to evolve into a better self. But we live in an ethos that recoils even from inconvenience–much less the troublesome effort to change one's habits … As Carl Jung insists, 'evading legitimate suffering that comes simply from dealing with the world we were dealt always ends in neurosis–anxiety, obsessions, narcissism, and blaming our faults on our personalities rather than blaming our personalities on our faults.'"[69]

The power to change often begins with the confession of powerlessness. Pain brings us to this threshold with unerring accuracy. It forces us to reckon with our inability to construct our lives according to plan. At first this feels like weakness, which is why so many of us shrink back from crossing this threshold. It is simply too difficult to admit our own powerlessness. Yet there is strength in weakness, because it allows us to exchange the illusion of a powerful self for the truth of an authentic self–a self unfettered by falsehoods and empowered by grace.

In the Christian tradition, power revealed in weakness is a divine paradox. The cross is the ultimate representation of this paradox, but the Bible is replete with stories of how human frailty invokes divine strength. When Jesus was making his way through pressing crowds to visit a dying little girl, a woman who had suffered for years with uncontrollable bleeding approached him from behind–"If I but touch his clothes, I will be made well," she vowed. Aware of this distinct touch amid the jostling

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and shoving because he felt power flowing out from his body, Jesus immediately turned around to see who it was. When the woman fearfully confessed to him, he responded, "Daughter, your faith has made you well; go in peace, and be healed of your disease."[70]

The divine empowerment is not necessarily physical restoration, however, as the apostle Paul discovered when he begged for deliverance from a tormenting problem, "the thorn in the flesh." Instead of responding as Paul had initially hoped, God gave him a paradoxical gift–the discovery of how grace comes not with the removal of suffering, but in the very experience of suffering itself, "for power is made perfect in weakness."[71]

The "larger life" we can discover through pain is defined not by miraculous restoration of health, but by the marvelous re-envisioning of existence that becomes possible when we face into our struggles instead of turning away from them.

hopelessness can lead to hope

Dietrich Bonhoeffer, who died a martyr in the German resistance movement against Hitler, wrote from his prison cell, "it is easier to suffer physical death than the pain of spiritual death."[72] In our fear, suffering looms as the ultimate enemy. But suffering is not fatal, only hopelessness is. Physical pain need not equal hopelessness, but that is the reality for some sufferers.

The good news is that hopelessness can lead to hope. Once all conventional sources of help have been exhausted, the work of the spirit often begins in earnest. This is the path that leads beyond despair to a discovery of something higher and deeper as a source of meaning and purpose. Thus the suffering surrounding an event may be the signal for authentic hope, a harbinger of spiritual awakening and rebirth.

Some people can walk the fragile ground between despair and hope. For others it is too difficult, and they need guidance and support to move beyond hopelessness. One of the missions of the Pain Center is to

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support those who are struggling for hope by helping them turn their backs on despair.

One of my patients, whom we affectionately dubbed "La Contessa," is from an aristocratic New Mexico family descended from sixteenth-century Conquistadors. When I began treating her several years ago, she was already in her eighties. An elegant and dignified woman, she frequently wore her hair up in a tiara fashion, projecting a sense of social prominence with grace and humility. A deeply spiritual person, she never appeared without her cross and rosary beads. Upon our first meeting, I was stunned to see how contorted her body had become as a result of scoliosis (curvature of the spine) and severe arthritis in her hands and feet. She suffered constant pain, extreme at times, but she seldom manifested that pain through her behavior and rarely complained. In contrast to her deformed limbs, she radiated a joyful spirit through her shining eyes and smiling countenance. There was a power about her that commanded respect–indeed, I knew she was greatly revered by her children, grandchildren, and great-grandchildren.

As so often happens, the patient cares for the caregiver. It was clear from the outset that La Contessa was teaching me a crucial lesson of the heart. What had this lady learned that enabled her to be joyful while enduring virtually continual pain? Now in her nineties, she hardly ever voices discontent even though she is barely able to walk, and she is frequently awake during the night trying to reposition herself to ease the pain. Yet she is always giving to others–to her grandchildren, to her children, to the community, even to her physicians. She will often bring me a plate of biscochitos, traditional Spanish cookies.

At long last, I asked La Contessa what enabled her to focus beyond her pain and become such a spirit-filled person.

"For many years now, Dr. Hinds," she replied, "I have realized that my failing body is just a cocoon. It is a chrysalis, which is becoming more rigid and of less value. But the eternal spirit within me is getting ready to become a butterfly, which will emerge and go to eternity."
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La Contessa might have spent her time pining wistfully for her youth and outward beauty, which had long since faded. She could easily have yielded to despair over her increasingly crippled and painful body. Instead, she allowed these losses to inspire hope by viewing them as reminders of her coming transformation.

Indeed, La Contessa's transformation has begun already. She has discovered the gift of receiving in the act of giving. She will probably not live much longer, but her joy at the prospect of eternity and the radiance she gives to all those associated with her will linger in our memories when the time arrives for her to take wing.

Those who share La Contessa's belief in heaven–a life after death of blissful union with God in the redemption of earthly life–have a clear goal in which to place their hope. What about those who do not have religious faith? What does hope mean for them? In his description of pain patients who have "successfully coped" with suffering, Philip Yancey offers a very simple definition: "Hope means simply the belief that something good lies ahead. It is not the same as optimism or wishful thinking, for these imply a denial of reality."[73]

Pain patients have already had many hopes ripped out of their grasp. They know all too well what has failed them as a trustworthy source of hope, but they need not live in that failure. They have an opportunity to redefine the "good" in life. I have seen over and over again that those who seek, will find.

embrace mystery while you seek answers

Suffering is much easier to philosophize away when it happens to other people. "There's no reason for it; it's just random chance," some will say. "You just don't know where the roulette wheel will stop." The religiously fervent might explain it away as "God's will," implying that God wanted some terrible thing to happen, as if human beings are just pawns on an inscrutable divine chessboard. When suffering hits home, however, the explanations dissolve before the agonizing question,

"Why?"
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Some pain seems easier to bear if we think we know why it happened, or what purpose it will serve. Even bad answers seem preferable to no answers. The problem is that these "answers" can short-circuit the healing process in a kind of arrested development.

The paradox of pain is likely to take from you the meaning you thought you needed and replace it with a meaning you could not have anticipated. You will never get a satisfactory answer to the plea, "Why is this experience happening to me?" But you may be propelled into a new way of looking at your life with the question, "How is this experience teaching me about what is most important in my life?" If you keep asking the "why" question over and over again, you are likely to become entrenched–because, once again, you have been trapped into focusing on the pain, which will only intensify it. You are faced with a decision: respond to your pain by obsessing over it, or break the cycle by choosing to live with unanswered questions.

Despite my deepest desire for patients to be cured of their illnesses and to recover fully from their injuries, I look beyond the physiological healing for the profound inward healing of the heart. Pain can be the unwanted messenger that nevertheless gets our attention, the harsh teacher who leads us to the most important lessons.

There are times in my work as a healthcare provider when I feel a sense of failure because the pain persists despite all my attempts to alleviate it. Perhaps this is a reminder to be humbled by the knowledge that ultimately I am not in control. It may be an invitation to recognize that alongside my efforts to apply the latest research and the most sophisticated techniques in serving my patients, I must respect the holy ground on which we walk together. My professional drive to diagnose and treat with precision and accuracy must be tempered by the recognition that my patients' healing, and sometimes their injuries as well, involve mysteries beyond the reach of my extensive training and expensive technology.

Native Americans have a wonderful tendency to laugh at Anglo attempts to understand and master everything. Their ready laughter keeps them from taking themselves too seriously–a liability that is perhaps endemic

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to the medical profession. Native Americans would say that in times of pain there is a lesson to be learned, so look at the lesson the pain is bringing you. If you simply suppress it with medication or a procedure, you run the risk of failing to complete the process of learning whatever it is the pain may be teaching you.

Dan Namingha helped me understand that when you try to dissect the reasons for adversity, you risk destroying the mystery of life and death, and healing and suffering. Embracing the unknown is scary, but there comes a time when that is exactly what you need to do. Turning over your fear and resting in mystery is not a common practice in our society. When my patients go against the grain and accept their difficult circumstances instead of running from them, I see them begin to inhale a deep, refreshing calm. They are letting go of the burden of answers. Some of them shift the burden to God; others let it slide away in meditation as an illusory demand of the ego. Whatever their concept of mystery, embracing it becomes a healing way of responding to pain–a pain modifier.

accept the crucible of transformation

Suffering leads to the wisdom of experience. I have found that the wisest spiritual guides tend to be people who have learned to live with pain. They do not spout shallow advice. They speak from the struggle of their own experience, sharing what they have learned firsthand. These individuals model for me a way of walking through darkness, but they cannot learn my lessons for me. The only way I can acquire the wisdom of experience is the hard way.

Suffering exacts a great price, but it can also yield a great return: transformation. "The value of unmerited suffering," observed Martin Luther King, Jr., "[calls us] either to react with bitterness or seek to transform the suffering into a creative force." You may not have the ability to change the circumstances of your suffering, but you do have the ability to choose how you will respond to those circumstances. For some, this choice may be the only path of release. It is not merely a positive-thinking technique, an exercise in the power of the mind. It is, fundamentally, a commitment

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made on the level of the human spirit–a determination that engages the heart as much as, if not more than, the mind.

Acquiring the wisdom of experience necessitates walking through the crucible of transformation. When you accept instead of resist the lessons waiting there for you, you are doing more than employing a cognitive tool for attitude adjustment. You are ascending on a spiritual level to what may be a powerful transformation within the depths of your being.

All of life is, in a sense, a crucible of inward change if we are willing to harvest our experiences to gain wisdom rather than frittering the experiences away. But suffering can accelerate transformation. People will sometimes comment after a crisis, "I feel as if I have lived several lifetimes through this." That is because they have sustained a crash course in lessons of the heart: what someone else might learn in a four-year program has just been distilled into a month-long summer school intensive.

You would not volunteer for such a course of study. Only the rare few choose to submit themselves to suffering in order to grow from it. The rest of us are dragged into it kicking and screaming. Once you find yourself there, you can either keep kicking and screaming, or you can recognize that pain has placed you in a crucible for transformation. If you allow your suffering to change you instead of harden you, chances are you will not want to go back to being the person you were before the struggle. You will be too grateful for the person it has enabled you to become.

We tend to like surprises, but pain always arrives as an unpleasant and unwelcome surprise. It is an alarm that injury has occurred. After the initial shock, you may find that pain is bringing you a welcome surprise: it is helping your heart find its way back home. You would never have known the injury was there if pain had not revealed it to you. Now you have a chance to do something about it, to choose to move toward healing. Apart from how your body recovers from injury or rallies to fight off illness, the spiritual struggle that pain has pitched you into can open up matters of the heart. You may find that hidden hurts or unacknowledged emotional injuries are now emerging. Pain has revealed what

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otherwise would have remained dormant, and your heart is beginning to move from aching to healing. That is a transformation we all long for.

what you find may be worth more than you lost

Most of us think recovery means regaining what was damaged by injury or illness. In living through crisis, you may recover something that had been missing in your life before you sustained injury: perhaps a richer and more satisfying way to live.

"Those who find their life will lose it," Jesus declared, "and those who lose their life for my sake will find it."[74] The search for the good life can lead to an emotional and spiritual dead end if we attach ultimate significance to things that can easily fail us: material possessions, social status, relationships, or a physically comfortable life. Chronic pain or physical disability can make people feel that life as they knew it is over–which, in a sense, it is. They now have to forge a different way of life, and they may find that the new beginning is more significant than what has just ended.

Dr. Frank Vertosick describes this reversal of lost and found in the life of a woman with intractable face pain.

[She] enjoyed counseling other victims of face pain so much that she began to see her own illness in a different light. Without personally experiencing the disease, she would never have had the opportunity to minister to others. She found meaning in an otherwise meaningless malady and came to see it as a blessing. In a sense, she was cured, not by craniotomy but by a restructuring of her attitude.[75]

The title of Dr. Paul Brand's book, The Gift of Pain,[76] captures this paradox. We would not choose to experience physical suffering, but if we have the vision to see them, we may recognize gifts wrapped in the losses. The habit of paying attention to these hidden gifts can help awaken us to the goodness at the heart of life.
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Elizabeth O'Connor, author of Cry Pain, Cry Hope: Thresholds to Purpose, was a spiritual guide to thousands of people through her writing and in her personal ministry at an inner-city church in Washington, DC. She suffered from severe rheumatoid arthritis, which eventually confined her to a very restricted way of life. She learned to praise God for both her strengths and her weaknesses, to flow with what is inevitable rather than to fight it as a destructive enemy. "Once again the lion and the lamb in me approached each other and they lay down together," she wrote. "I saw how He who had made one had also made the other … As I move closer to the pain inside me, I found myself wanting to be closer to the pain outside of me." O'Connor had decided to be more of a support to a world in pain.

look for joy in suffering

Whether the crucible of pain leads to a hardening or softening of a person's spirit usually manifests itself in the absence or presence of joy. Certainly there is no joy in the pain itself. But I have observed that those who affirm some kind of spiritual transcendence–a life with meaning beyond earthly pain and suffering, whether now or in the hereafter–discover a joy that has nothing to do with happiness in the conventional sense. Stripped of the comforts that others can afford to take for granted, they are free to discover a life that no longer depends upon their ability to make it happen. It is defined not by what they can acquire, but by what they can receive.

During my thirty-five years in medicine, I felt the most selfless during my tour of duty in Vietnam. One assignment placed me as the commanding officer of a mobile clearing station–like a MASH unit, except not as advanced. At age twenty-six, after just one year of general surgery residency, I was in charge of 160 people: medics, x-ray technicians, and soldiers who protected us. We took in anyone who was injured and did the best we could for them. There were lots of them, every day. We patched up damaged limbs, tried to mend broken bodies, and cursed mortal wounds.

It had been a grim relief for me to go to Vietnam. I had left on bad terms with a woman, and the sense that I had nothing left to lose gave me a

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devil-may-care attitude. It was frightening nevertheless, and it was constant work. Our remote location removed us from all distractions–no girls, no places to shop, no idle time to kill, and no self-preoccupation. I was able to focus entirely on serving others.

One morning I woke up and realized that I actually felt joyful, because I was able to live each day outside of myself. My mission was simple: take care of as many people as possible, and give everything I could in the effort to do so. I have never captured that sense of selflessness since then, and I have never again tasted quite the same joy.

Feeling good does not necessarily mean feeling joyful. Feeling good will not sustain you in the crises of life. Finding a solution to your pain will not necessarily bring you joy. The surprise in suffering is that it may help you find interludes of joy and peace, which will sustain you when you are not feeling good. My friend Sister Mary Joaquin at Christ in the Desert retreat center, suffering with terrible arthritis, is very clear on the distinction between feeling good and feeling joyful. One is a mental and physical condition; the other is a spiritual reality.

practice gratitude amid loss

I have a place of retreat in Colorado along the western edge of a mountain pass. The house sits on the bank of the San Juan River in a cleft surrounded by ancient and majestic mountains. I have cultivated the land to help nurture the living things that depend upon it, especially by planting trees. On the north side of the house I am particularly proud of three young ponderosa pines thriving on the rocky slope overlooking the river. They are the surviving remnant of fifty tiny seedlings I planted with great care, investing many hours of time. Visitors inevitably cluck with disappointment over the forty-seven trees that didn't make it, but I feel fortunate to watch these three now becoming a permanent part of the landscape. They remind me to be grateful for the miraculous presence of living things in the vast web of life that connects us all.

One of my patients was a well groomed, middle-aged, matronly woman. Examining her chart, I discovered she was HIV positive. She had a type of neuropathic pain often seen in AIDS patients. She told me that

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after her first husband died, she remarried. She subsequently found out, while pregnant with her second husband's child, that he was HIV positive. Her daughter is now ten and HIV negative. Her second husband died in 1992 of AIDS. She has now converted from HIV positive to AIDS. She continues to be calm and sweet, with a surprising sense of peace.

While I was performing a risky and painful procedure on her, I felt her peacefulness transmitted to me. When I later told her that it was an honor to help her with her pain, she commented that her situation had become a gift. Through her dark night of the soul, she had grown so much spiritually that she felt she'd been given a glimpse of eternity. This would not have happened, she said, without the devastating diagnosis. Even under such terrible circumstances, she would not choose to go back to where she had been. Although her worry is now for the health of her young daughter, she is grateful for the inward renewal that emerged in her sojourn through deep valleys and her struggle to maintain some degree of health and equanimity.

Loss has a way of forcing us to give up our personal agendas. When we stop making demands for what we want, we will have room to acknowledge what we have.

wholeness comes through brokenness

When difficult experiences reveal how incomplete and fragmented our lives are, we confront our vulnerability to confusion and helplessness. We come face to face with our brokenness–not just the broken back, but the broken spirit that cannot deal with the broken back. We mourn the untimely loss of childhood because our intense society does not allow time and freedom to be a child. We live with the bitter failure of an intimate relationship because we have displaced all our energies in striving for the life we thought we needed.

When circumstances force us to examine our incompleteness, it raises the possibility that we can gather these fragments into a whole. The drive toward healing is the recovery from the losses associated with the pain and suffering. As the body strives to overcome injury and recover physical wholeness, spiritually we strive to heal heartache and recover

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an internal sense of wholeness. When suffering is transformed from meaningless loss to a redefinition of meaning and purpose, wholeness no longer depends on physical health or outward accomplishments. It arises from the recognition that what happens in your heart is more powerful than what happens in your body. It is felt in the inner peace of realizing that external losses can give you a greater awareness of where your life is truly centered. You can meet loss with acceptance, because instead of pulling you apart as you feared, it can help put you back together in a new integration of body, mind, and spirit.

Dr. Rachel Naomi Remen, bestselling author of Kitchen Table Wisdom,[78] believes that healing of our fragmented culture will come through the heart. Her focus on giving "blessings" by affirming the goodness and worth of each individual is partly a consequence of her struggle with complications of Crohn's disease, which struck her at age fifteen. This illness, not her medical expertise, has shaped her work of compassion and caring. Her recent book My Grandfather's Blessing[79] recounts the spiritual influence of her grandfather, a rabbi, who taught her the importance of connecting with others. "No one has ever said to me 'If I die of this illness, I will miss my Mercedes,'" she observed. "Yet pursuit of the Mercedes has been their whole life." Illness triggers the realization that "what truly matters, at the edge of life, is who we have touched." Dr. Ramen considers her illness a blessing, because it has made her a much wiser person: "I could not do the work I have done had I not had experiences that were terribly painful. If we stand before people with all our strengths, joys, pain, and imperfections, others will not feel alone or ashamed." Her perspective reflects the Jewish tradition that wholeness is achieved through brokenness: "Everything in our lives can be used to serve others. Our strength comes from our wholeness, not from our perfection."[80] A renewed understanding of what it means to be a whole person includes weaknesses as well as strengths, limitations as well as achievements. This understanding can lead to such a strong sense of integration and purpose that many people will declare, quite genuinely, that they would not want to go back to who they were before the onset of illness. There is no turning back; they are too grateful for what they have discovered in the struggle.
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If you suffer from chronic pain, you will inevitably confront the pain paradox. The infirmity might not ever go away, or it may take a different physiological form, but the pain may lead you on a journey toward wholeness. May your own lessons of the heart, however costly, become your personal treasure–the pearl of great price you discover while turning over the soil in the field of struggle.
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STEPS FOR THE PATH:

practicing renewal

1.

Today, I would rate my general pain level as:

0

1

2

3

4

5

6

7

8

9

10

pain free

excruciating pain

2a.

To help you assess the progress you have made in breaking the cycle of chronic pain, use the following scale to describe where you are now on the continuum from entrenchment to renewal (a "10" represents the most positive position on the scale).

0

1

2

3

4

5

6

7

8

9

10

depression

hope for the future

0

1

2

3

4

5

6

7

8

9

10

deactivation

reactivation

0

1

2

3

4

5

6

7

8

9

10

dependency

self-reliance

0

1

2

3

4

5

6

7

8

9

10

doctor-seeking

responsibility for my wellness

0

1

2

3

4

5

6

7

8

9

10

drug-seeking

pursuing alternatives

0

1

2

3

4

5

6

7

8

9

10

deteriorating relationships

renewed relationships

0

1

2

3

4

5

6

7

8

9

10

dormant spirituality

spiritually active
146

2b.

Compare your responses to the chart above with those you indicated on the same chart in chapter two. What has changed, and what has stayed the same?

3.

How would you describe your areas of greatest growth?

4.

Summarize the new or most helpful insights you have gained for living a life larger than your pain.


[67] Menachem Mendel Schneerson. Toward a Meaningful Life: The Wisdom of the Rebbe, adap. Simon Jacobson. New York: William Morrow, 1995, p. 128.

[68] Frank T. Vertosick, Jr. Why We Hurt: The Natural History of Pain. New York: Harcourt, 2000, p. 102.

[69] William J. O'Malley. Making Sense of Suffering and Death. America 13 April 1996, p. 9.

[70] Mark 5:25-34, NRSV.

[71] 2 Corinthians 12:9, NRSV.

[72] Dietrich Bonhoeffer. Letters and Papers from Prison. London: SCM Press, 1954.

[73] Philip Yancey. Where is God When It Hurts? Grand Rapids, MI: Zondervan, 1990, p. 210.

[74] Matthew 10:39, NRSV.

[75] Frank T. Vertosick, Jr. Why We Hurt: The Natural History of Pain. New York: Harcourt, 2000, p. 278.

[76] Paul Brand, Philip Yancey. Pain: The Gift Nobody Wants. Grand Rapids, MI: Zondervan, 1993, p. 21

[77] Elizabeth O’Connor, Cry Pain, Cry Hope: Thresholds to Purpose, Waco, TX: Word, 1987, p. 128./p>

[78] Rachel Naomi Remen. Kitchen Table Wisdom: Stories that Heal. Riverhead Books, 1977.

[79] Rachel Naomi Remen. My Grandfather's Blessing. Riverhead Books, 2001.

[80] Quoted in "Healing words from a doctor," by Beth Ashley. Marin Journal, 5 May 2000.

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