Swan Song: A Reflection on Pain
Oh, my agony!
- My Chemical Romance
I’ve always been fascinated by the body’s seemingly endless capacity to feel pain of all kinds. With every twisted ankle and hug goodbye and bit of damaged cartilage and last look, I wonder whether I’ve finally hit my limit. I wonder whether the bolt of agony that will inevitably shoot out and up from my knee will be any less wet, or whether my squealing heart will feel any less sour. It never is, and nothing stops aching.
Of course, I don’t know why I always default to speaking of emotional pain and physical pain — my queerness and my disability, to use the more appropriate identity markers — as though they’re of different types or kinds. Some part of me wants to be assured that one is any more bearable than the other, and for that to be the case, they have to be different.
In some respects, pain certainly can be spoken of along those two axes: the physical and the emotional. But, when put between hospital beds and loneliness, who could even have a preference if you know what they’re like?
From the age of thirteen to eighteen, both of my kneecaps spontaneously dislocated multiple times, somewhere in the ballpark of ten times for each knee. This is what we call chronic patellar instability. Dislocation causes immediate, severe, unbearable, paralyzing pain, rivaling if not exceeding that of a broken bone. Reduction, or re-location, of the patella relieves much of this pain, but a severe ache persists for days, if not weeks, afterward, and one’s leg shakes, unstable, for much of that time. I didn’t receive medical attention until I suffered a major episode of instability at age fourteen, dislocating my right kneecap while acting when I made a sharp turn. From the time of my first episode at age thirteen — which took place while descending stairs, also acting — to when I received medical attention, six or seven of my total ten occurred. Nonoperative treatment emphasizing physical therapy and strengthening was preferred by my surgeon. This failed once at age sixteen in Milwaukee, Wisconsin, when I suffered an episode of instability dislocating both kneecaps at the same time while playing basketball, and again at age eighteen in Brooklyn, New York, when I dislocated my left kneecap while dancing. The latter failure I kept secret.
Although this was the last time I experienced significant instability, chronic pain and deep anxiety about future episodes persisted. At age nineteen, I began to suddenly experience intermittent intense, sharp pain under and around the left kneecap, making it difficult to walk and use stairs. Two months later, in winter, X-rays and MRIs revealed the presence of four or five bone fragments — likely broken off from previous injuries — moving freely in the joint, causing the above-mentioned pain and bearing the potential to gravely damage the major structures of the joint. These are what we call loose bodies. I underwent surgery less than a week later to remove them, and after four weeks of initial recovery, I returned to New York, where I continued to receive physical therapy until a second surgery at age twenty, in the summer, to stabilize the now-weakened knee and repair cartilage also damaged by my many episodes of instability. In the course of recovery, I was unable to bear weight on my left leg or walk normally for ten weeks. I am still, at the time of this writing, considered to be in recovery from this surgery.
It is successful so far, but chronic pain persists, albeit with varying severity, and likely will for the rest of my life.
My heart has swelled and shriveled and dried and frozen over countless times, but it’s only broken
in that proper,
(breaking up is haaard tooo do!)
i. high school
ii. college, close enough I still feel it floating all around my body — from throat to stomach, and stomach to toes and fingers, shiveringsick with hurt.
Unlike the ooey-gooey details of my weeping body, the details of those two queer not-romances don’t come quite as easily. The pain of hearing them trumpet from my fingertips or from my tongue is nearly too great.
[pictured: the cane I had to use when recovering from each injury, because proprioceptive issues as a result of brain damage at birth precludes the use of crutches;
a compression sleeve to combat postoperative swelling with two spiderweb braces, still in their plastic covering, to assist my knees in times of particular pain and instability;
my most recent prescription of Vicodin, to manage my pain]
[not pictured: my roommate, who had to take the picture of the cane because I still cannot kneel, and thus, cannot get on the floor to capture the right angle]
The reasons for not detailing my two instances of gay-love-pain are multifarious to the point of ineffability. But I ought not avoid it altogether. And, when I cannot communicate something precisely, guesswork must make do. And if I had to guess, it comes down to three things:
one: to feel such a private pain publicly, especially when there is no culprit to be had, is unfair to the others involved — because, though I speak of my pain, I implicate the inner lives of others by doing so;
two: although I still feel shame at my physical condition, I fear the queerer side of me stirs even more discomfort. It is pain unto itself. And
three: heartbreak is acceptable and interesting as an intellectual exercise, in the abstract; it’s only when I name it, ground it in a body, a person with eyes, legs, voice, hips, laugh, ass, smile, arms, when I admit that I love an individual, with an inner world and life and face all their own, does it seem petty, carnal, and dreadfully mediocre for something that makes my heart keen and makes my nerves weep and gnash figurative, cellular teeth.
No pain can be poetry or intellectualized, though, at least not when pain is the proper subject. It’s immediate, ugly, desperate, and all fundamentally the same. This is when the divide between my knees and my heart blurs, vaporizes, vanishes from existence.
When you’re on the ground, a wrist or knee or ankle aiming the wrong way, all you can say of it in the moment the pain hits is it hurts! it hurts! it hurts! and maybe make it stop! When someone doesn’t love you back, or your friend says something mean, or someone calls you a slur, all you can say of it in the moment is it hurts! it hurts! it hurts!
And, of course, make it stop!
There’s something uneasy about wanting to fall in love while inside a body wanting to break down. Every moment seems a potential swan song: the last foxtrot or last waltz or hell, even the last headbang before my body fails once and for all. What guy wants to kiss-fuck-love a splayed-out heap of bloodnguts and agony, a bagobones where joints never face the right way and everything hurts just to move?
“You know, I’m not sure the pain’ll ever really go away fully,” my physical therapist says. The tone is vague, like meteorology. Entirely unsolicited. Her hands work hard at getting the muscles around my knee to relax.
My skin feels like starbursts, especially around the scars, which isn’t a good thing. My neck tenses as I lift my head to look at her. “Oh, really?” I ask. I make it sound more like curiosity than panic. Although, of course, when it comes to pain, panic no longer feels new.
“Yep.” It’s a matter of fact. “We never like to see it happen, but really, you’ve had so many issues that the nerves are probably just going to be that much more sensitive to any little disturbance.”
And then: “But that’s probably something to talk to your surgeon about, just to be sure.”
Therapy continues. I can feel supernovas winking up and down my leg.
Talk of pain is so free and wide that its nature, its properties, what it feels like, seems to escape us. There are a range of words we might choose from — sharp, achy, burning, dull, uncomfortable, excruciating, on-a-scale-of-one-to-ten, numb — but on the Bad Days and in the moments of feeling ever so alone, the hurting is more intimate than any utterance can capture.
When my body goes haywire, pain becomes my body. When someone doesn’t love me — either anymore or never to begin with — pain loves me and I love it, because what else would love me, and what else could I love, anyway?
Almost anything can cause my knees to pop, lock, and grind: a step forward, a step to the side, a step backward, going up stairs, going down stairs, dancing, smiling, loving. The surgery’s made things more forgiving, but I still avoid making wrong steps
(except that one time the day before spring break when I was so drawn to this guy’s face and eyes that I turned my head to keep looking at him and dropping off the sidewalk my ankle folded under me and I heard a pop and my knees still fresh from the first surgery slammed into the street and I had to miss learning about the history of modern philosophy and I never saw that guy around campus again and I felt like god was punishing me for being gay and even though the doctor told me I’d be better in two days max I ended up not walking semi normally until the end of break and even though the swelling eventually went down it still hurts from time to time even today months afterward).
My surgery has a ninety-eight percent chance of successfully preventing another episode in my knee, but the creaking achy-breakiness might never go away.
Surgeries and advice columnists and crossed arms seem like useless rites in the face of chronic pain, chronic heartbreak, a boundless array of potential and certain bone-breaks, unread messages, joint-strains, goodbyes. If the moments of pain are infinite in number, one less seems more like spit in an Olympic pool than a drop in a bucket.
But dancing, walking, laughing, twist&shouting, a moment of wonder at how pretty someone is, inside and out, a gleaming in their eyes that makes everything seem to sing, are these not how we cope?
The romantic poetry of Petrarch and later sonneteers of the sixteenth century fixated on the contradictory nature of love, its ability to burn and freeze, make quiet and make war. When I feel my heart go into a tailspin at the thought of an unrequited love, that sinking feeling isn’t just of despair, but thrill as well. The last time I injured me knee, I was headbanging.
[pictured: my scars from my most recent major surgery, consisting of three small scars around the kneecap to perform an arthroscopy and lateral release, in which the joint is filled with saline, and the tough, fibrous scar tissue pulling the kneecap to the outside is cut;
one slightly larger scar on the far inside part of my knee as part of a medial patellofemoral ligament reconstruction, in which a ligament taken from a cadaver is secured with plastic screws to replace my ruptured, naturally-occurring ligament to pull my kneecap inward;
a larger-still scar on the side of my kneecap to complete the reconstruction as well as part of a cartilage implantation, in which the kneecap is flipped over, and generic cartilage cells are put over areas of damage from previous injuries and held in place with a mesh to regrow the damaged cartilage;
the longest scar running down my shin as part of a Fulkerson osteotomy, in which a sliver of my tibia connected to my patellar tendon is cut away, moved slightly inward, and reattached to the tibia with two metal screws to aid the kneecap’s gliding motion]
[not pictured: me, grimacing and unsure of whether to reveal how ugly my leg looks now, but doing it anyway]
After the Second Heartbreak, I cry uncontrollably in the park.
I didn’t think it would hurt this bad, I weep,
embarrassed how epistemically inept I’ve been.
I didn’t know.
I shouldn’t have said anything,
shouldn’t have told.
I’m so stupid.
I’m so stupid.
I’m so stupid.
My friend tells me I’m not,
to honor the feelings, all of them as they come. Pain included.
To write, if it’ll help.
I do, eventually.
Whenever a faulty joint or averted gaze carves out a hollow place within me, I feel something else besides pain filling it up, entwined with the make-it-stops and the it-hurts like a lover. I feel the world.