One night a few summers ago, I fell asleep fine but woke up dizzy and sick. My mom rushed me to the hospital. I was given a bed and an IV. The doctor introduced herself.
“It might be bacterial meningitis, so we’re going to test for that right away,” she told me. “Otherwise, it could just be a summer bug.”
She said she would return soon with a nurse and “equipment.”
My mom bit her lip. “You’re getting a spinal tap,” she said.
I had heard that spinal taps are among the most painful medical procedures. My love for the rockumentary of the same name strangely made it more daunting. A nurse came to turn me on my side. She spread freezing cream on the skin above my tailbone. The doctor returned, hands full.
“This will sting,” she said.
I looked for a place to put my anxious hands. An odd notion of corporeal economy persuaded me to hold one in the other.
“Now keep perfectly still,” the doctor ordered.
“Who can remember pain, once it’s over?” wrote Margaret Atwood in The Handmaid’s Tale. “All that remains of it is a shadow, not in the mind even, in the flesh. Pain marks you, but too deep to see. Out of sight, out of mind.” Think about a time you slammed your finger in a door. Or stubbing your toe. Anything more than faint?
I do remember what I felt immediately after my spinal tap. The doctor slid the fluid-filled syringe out of my lower back, inducing a sort of post-pain, the fleshly equivalent of an afterimage. It was a harsh absence centered where the pain had been. I also felt relief and sadness, a peculiar sadness that reminded me of the indignation I felt in middle school when an older kid would punch my shoulder hard for no reason. My visceral circuits seemed to want to ask the doctor, “Why me?”
Then came pride. I hadn’t squirmed or moaned during the procedure, only clenched (everything). But my pride was personal as well. Before the spinal tap my life had been easy, sensorily speaking. The two fingers I fractured at age four by jumping off the bed were the only bones I’d broken. The spinal tap was my first experience of Real Pain.
So I needed to tell people right away. I threw manners to the dogs. At dinner with my family the night I came home from the hospital, I described the lumbar incision over pork chops and rice. I went out with friends and talked needles and blood as they bit into their burgers.
What must have made my morbid monologues even more unbearable was my inarticulate performance. My memory of the tap was a shadow; the words didn’t quite flow:
“It was piercing, you know. It went in at the base of the spine and—you know what getting a shot feels like. The needle went in, and the spine is very sensitive, so—it was like tenderness mixed with pain. Anyway, it came back negative. But you know, the worst part was the initial puncture…”
Describing any sense of impression is difficult, but it’s especially difficult when the sense you’re trying to describe doesn’t get along with memory. How could you feel someone else’s pain if you struggle to recall your own?
Communicating pain is an intellectual problem, but it has political significance. When it came out that the CIA was waterboarding detainees, the question became whether that meant America uses torture. The Bush administration’s definition of torture excluded subjective accounts of pain. It’s only torture, the administration argued, if it leaves permanent damage. If communicating pain is impossible, then the administration was right: the only verifiable markers of severe pain are scars and brain damage, so the only workable criterion for torture is observable (i.e., permanent) harm.
Is such communication impossible? There are several methods that don’t work, of course. “Tender,” “harsh,” and other abstract adjectives do nothing to the mind. They’re like fleas bumping into the side of a house. Analogies work better. They point the mind toward a sense-memory; at least it starts with something real.
But analogies hit their heads on low ceilings. Spinal taps occupy a different class of pain from vaccinations. And what if you lack the experience that an analogy assumes you’ve had? Christopher Hitchens agreed to be waterboarded for a Vanity Fair piece, in which he wrote that the common description of waterboarding as “simulated drowning” is false: being waterboarded is drowning. It was a powerful description, but it means nothing to people who haven’t suffocated underwater. And even if you have had the experience that an analogy presumes, your memory of that experience has by now dimmed to a shadow.
Why describe pain in the first place? With my family and friends, it wasn’t that I wanted to give them the same pain I endured; that would’ve been sadistic, but also hopeless. Words can’t break the skin. Recognition was part of it, not all. The universal fear of spinal taps means that merely mentioning you’ve had one wins you prestige, and I knew this. Something else must have made me go into detail about the pain.
I think when I left the hospital, I saw myself as a correspondent from Taptown, someone blessed with the perverse privilege of uncommon experience. I had been tapped. Thus enriched, I was compelled by a kind of noblesse oblige to redistribute the wealth.
I wanted to bring other people as close to my experience as possible. I could make them feel like they were in the room with me. Isn’t this what we say about good description: “I felt like I was right there with you”? People in the hospital room with me saw, for example, the doctor “slid[e] the fluid-filled syringe out of my lower back.” Imagery like this makes you feel like you’re seeing it live. It makes you recoil, which signals empathy.
This aspect of empathy—that it is activated only in the third-person—means it’s entirely other-directed. It responds to the sight of someone else in pain, and it triggers a protective and sympathetic instinct towards him. This makes it an emotion essential for cooperation. But the reason why it sometimes fails, the reason for so much suffering, is that empathy requires the Goldilocks amount of imagination and memory, two faculties with inherent shortcomings.
These shortcomings pile up in the spaces between people to block the communication of experience. Only concrete language can shovel the shit away so the message can make it to the other side.