Wednesday, February 22, 2006

Pain in the existence

Despite (because of?) all the nice yogic principles and teachings we picked up on Sunday, I injured my back in the process, and spent the last fifteen minutes of Shiva Rea’s Dancing Warrior series in Child’s Pose.

I have had back problems for years. This episode didn’t feel a lot different than previous ones, so it isn’t like I didn’t know I would heal (or, rather, “will heal,” since I’m still not back to normal yet). It was probably exacerbated by dehydration from too much yoga and not enough water during the day. But by the time it forced me to pay attention to it, I was something of a wreck. I felt claustrophobic in the too-crowded, too-hot, too-humid, not-oxygenated-enough room. My flight impulse was reaching a pretty high level, compounded by my mind which was angry about the injury and disappointed that all of the high rhetoric of yoga during the day led to such a mess of a situation in the evening.

At that point, I remembered Dave suggesting that injuries can be some of our best teachers, so rather than leaving class, I knelt in Child’s Pose and breathed. There still didn’t seem to be enough air in the room. But I felt that, too, and breathed. Soon, the class ended, and I limped my way to my car. I was in wet yoga clothes, and outside temperatures were in single digits. I started to drive home, only to realize that I was nearly out of gas – literally, as well as metaphorically. I stopped at a gas station, and filled the tank, standing in the wind, and shivering uncontrollably.

When I finally got home, I was a mess. My wife, bless her, ran a hot bath for me, nipping the incipient hypothermia; filled me with several liters of water, fixing the dehydration; and generally sympathized with my pathetic state. At that point, I could focus on my back injury. I concluded that it wasn’t likely to get better very quickly, so I cancelled a professional engagement the next morning, took gobs of ibuprofen, accepted a Ziploc bag of ice for my spine that my wife proffered, and hunkered into bed.

The next day, I kept thinking about Dave’s injury-teacher connection. And I learned this: if I feel back pain not as some massive, recurring curse on my existence, but as simply an element of what I’m feeling at this very instant, even bad pain isn’t too bad. It’s as if pain is really just one more sensation to be experienced. Mind you, I’m not advocating intentional self-infliction of pain. But I began to realize the Buddhist distinction between pain (a temporary sensation) and suffering (a state of mind).

In this regard, one more dip into the archives, to provide more context to the experience of pain:

May 26, 2005

I go into my dermatologist's office to have a mole removed. (I'm a speckled critter.) I lie down on the table, as the mole is on the back of my left shoulder. The doctor injects my shoulder with Lidocaine, which promptly numbs up the work site. The doctor begins her work with a scalpel, digging out the mole. That only takes a few seconds, but the hole is relatively big and deep, so the next ten minutes are spent stitching up the hole.

Like most doctors, this one is careful with her stitches, and wants them to hold very tightly, so there's a fair amount of pushing and pulling: pushing to get the wound open enough to get the stitches into the deep part, pulling to get the suture tight, pulling to tie the knot, pushing to open the shallower part of the wound to get in the next stitch, and so on. No pain. Just pressure, pushing and pulling.

But my reptile brain is totally at work.

First, I can feel my hands and feet going cold as my autonomic nervous system cuts of the supply of blood to them.

Next, I can feel a cold sweat break out on my scalp and forehead.

Then I can feel something decidedly odd occuring in my heart space and belly. No way to describe the feeling but "awful." I'm breathing through this, but I can't manage to concentrate on anything -- it's like my higher brain functions are foolishly scrambling around on the deck of a ship while my lower brain is causing a tidal wave from beneath.

The surgery, of course, was entirely uneventful. The doctor and I chat through it. Soon, the doctor finishes, bandages the site, gives me instructions on wound care, and leaves for her next patient.

I'm left in the room to re-dress. I take a few more breaths and roll over. I feel better than during the procedure, but far from great. I get up and go to pick up my shirt.

I black out almost completely, and promptly sit down on the table. My vision comes back, I breathe a few more times, feel better, dress and leave. I'm learning not to underestimate the power of that reptile brain of mine.


May 31, 2005:

I need to fill in the parts of the last story that I left out originally -- in part because I wasn't sure that they informed the story, perhaps in part because I hadn't finished digesting them, though another unexpected and fortuitous solo session with a favorite yoga instructor on Saturday changed my perceptions more than a little.

To tell the whole story, I have to go back a couple of years to a dental appointment.

I go in to have my annual (which occurs only about ever three years or so) dental exam. The x-rays show that I've got a bit of decay in a tooth where I'd previously had a filling, so the earlier filling needs to be drilled out, and then the decay, then a new filling.

The dentist shoots me with Lidocaine and starts drilling. The tooth isn't, in the slightest, numb, but the drilling out of the old filling isn't too painful until the dentist gets through to nerve. I stop him and point out the problem.

He injects me with more. We wait a couple of minutes. No effect. He injects me with more. We wait a couple more minutes. No effect.

He tells me that on rare occasions with teeth positioned as mine are, external injections of Lidocaine can't actually reach the nerve. He also tells me that he's now given me all the Lidocaine that he can lawfully administer, and he asks me what I want him to do.

The tooth is open to the nerve. The decay remains in place.

I tell him I would like a couple of minutes by myself. I practice ujjayi breathing and find myself rather quickly in a clear meditative state. The dentist comes back in, and I ask him to go ahead with the procedure.

He drills. I feel the pain. I am 100% aware of the pain.

And I am also aware of the difference between my awareness and the part of my mind that is experiencing the pain.

And I hold still, watching the observer observing the pain. A couple of times, I feel my mind sliding back to becoming only the experience of pain, but I keep doing ujjayi breathing.

The dentist finishes the drilling and then fills the cavity, shapes the top, polishes it, and we're done.

Since that experience, on occasions when I've experienced significant amounts of pain, I've found it useful to practice ujjayi breathing techniques -- not to reduce the pain, as it doesn't, but rather to experience the pain without allowing it to overcome and take control of my mind.

Ok, that's the backdrop. Now the dermatologist -- I've reflected a number of times on my experience with the dentist, and I've wondered whether what happened that day was simply a "moment of grace" that I shouldn't expect to repeat, or whether it was just the way minds and ujjayi work.

So I started thinking along these lines, "Isn't a minor surgery like this a good opportunity to see what the experience of pain is like? It's a very minor procedure. If things start to become unmanageable, I can always ask them to stop and inject Lidocaine."

The dermatologist is a acquaintance of mine -- a social, but not really personal, friend. So when we get into the procedure room, I say, "I'd like to propose something a little unusual in this procedure." She stops and asks what. I tell her I'd like her to do it without anesthesia. She looks startled, then flustered. She asks if I'm allergic to anesthesia, I say no, I'm just interested in experiencing the procedure without anesthesia, as I think that my meditation practice would enable me to do so.

She ultimately says she isn't willing to go that route this time. She notes that she'd be willing to consider it further next time around. I tell her that she's missing an opportunity that doctors worldwide have always sought -- a chance to perform surgery on a lawyer without anesthesia.

She chuckles and injects the Lidocaine. As she works, I realize -- and mention to her and she confirms -- that the anesthesia of the patient actually makes the surgeon's job easier, as it allows the surgeon to act without empathetic regard to the pain associated with a procedure. So though I'm the one drugged, it isn't for my benefit alone, even assuming I can hold stock-still during the procedure.

When I wrote the prior post, I started to describe that experience in more detail, but I hadn't figured out whether it was simply a function of an odd kind of machismo, an over-inflated sense of my own meditative abilities or naive curiosity or simply something that ultimately didn't really happen and so wasn't worth retelling.

But, as I noted above, Saturday, I happened to be (again) the only participant who showed up for a class taught by my favorite yoga instructor (whom I'd tracked to a new yoga studio near my home). Since we were the only two there, we promptly abandoned the standard 52-pose Bikram series and spent about an hour talking and a half hour working on integrating Iyengar practices into navasana -- boat pose.

During the talking portion, I mentioned the interesting but rather negative experience with the dermatologist and my prior experience with the dentist. My yoga teacher suggested that perhaps the difference in experience was a function of part of my body experiencing the pain, but my mind lacking the consciousness of pain. I have wondered to myself whether the experience I did have was perhaps worse without conscious awareness of the pain that "should" have been there than it would have been with it.

There is, perhaps, an integrity to experience that includes physical pain that is absent from such experiences where pain transmission is dulled or blocked. The mechanical and scientific part of my brain keeps saying that the Lidocaine prevented the nerve signals from being transmitted to my brain, and so, effectively, there was no pain. But I've come to trust the yogic view of the world when it speaks of individual cells perceiving and experiencing reality.

Part of me experienced cutting and removal and stitching. My conscious mind was impeded from that understanding. Next time, I think, I'd rather have the whole experience. Not just a part of it.