A few years ago, I found myself exchanging stories with Lilly, a cafe owner. I work in India in the field of global health, and I mentioned how I’d been diagnosed with tuberculosis a decade ago. Her eyes lit up with surprise and a subtle delight. "Wait--you mean consumption is a real thing?!" It was as if all the literary worlds depicted by Charles Dickens and Emily Bronte suddenly came to life in her mind. I adored her reaction. It reminded me of a time at the airport when I stumbled upon a box of Turkish Delight (a confection I’d always believed to be fictional), and for a split second thought “Oh my god, Narnia is real?!”
(Reference: Turkish Delight is an enchanted candy used as a lure by the White Witch in C.S. Lewis’s Chronicles of Narnia)
Lily’s next question was “So what did it feel like?” I couldn’t find the words to give her an honest answer, but I did recall an image that stayed with me during my illness: A giant testosterone-fueled, thick-bearded woodsman with a felling axe. He would swing this axe, arching back and propelling forward with all his force to carve a dent in my lung. He did this again and again--his arms moving in a perfect continuous arc with such precision and relentlessness. Throughout the illness, I almost always had tears in my eyes due to the cough reflex, but some of it was also from the sadness I felt seeing the fierce intent in his eyes. This dude did not want me to live, period.
I’m continuously surprised at how stunted our language is in its ability to describe pain. We seem to only grasp at its shadows with metaphors—and that too not to describe the totality of the pain experience but just enough to distinguish one type of pain from another. Chronic cough can feel like anything from a game of whack-a-mole to a grinding axe. All the different types of ‘pain in head’ associated with depression and anxiety have to succumb to metaphors because there is no obvious physicality or locus of pain. Unfortunately, the medical community relies on frequency metrics and Likert scales to understand this phenomenon. If diagnostic criteria made room for metaphoric expressions of pain, we’d probably understand, empathize, and treat people better.
Constructing a metaphor is not really an easy task either. It requires a detached observer-state to isolate and examine the feeling of pain while simultaneously coping with it. The murdering woodsman manifested as a metaphor for me because tuberculosis fundamentally felt psychotic.
But there are also pain experiences that I believe completely elude all language and metaphors. About a year ago, I brought up the topic of sexual assault to a male colleague. As soon as I mentioned these words, his expression turned into something that resembled disgust. All the organs on his face contracted as if I had stuck a piece of rotten fruit in his face. I was confused by his reaction until I realized that it’s not possible for (most) men to empathize with sexual assault. It’s an abstract horror. There is no language to communicate the pain experience, and so it remains unknown. Women who experience sexual assault (across the entire spectrum of sexual violence) are unable to describe it even as an abstraction. The dissociative response to this type of violence doesn’t allow the mind to observe the pain. We often hear the vocabulary of being “humiliated”, “loss of dignity”, “objectified”, but most all women agree that this is an incredible failure of language. Women are often portrayed as paralyzed in the aftermath of a sexual assault-- attributed to feelings of guilt, shame, or fear. Although this may be true, the physical and verbal paralysis is also because there is literally no way to explain the pain to one’s own self, to make the body understand.
I don’t know if vocabulary for pain can be invented. Over time, it seems like pain will be less of a feeling and more of an emergent property. Metaphors will no longer be sufficient, at least not in their current forms of expression. I imagine them to be full-blown character narratives that will co-evolve with the pain experience. The murdering woodsman will start to change his clothes, trim his beard, and build himself a shed where he can sharpen his blade.
I'm not even sure how to respond to this. Just... you're right? Absolutely right. It's a sad irony that pain prompts such a desire for connection and communication while also defying the words most people need to build the bridges.
I’m happy to say I’ve not experienced ‘consumption’ or tuberculosis or any chronically painful physical condition/problem. Your metaphor of The Murdering Woodsman does indeed help me have empathy for your past experience of the pain of consumption/tuberculosis and for all the others who have and have had that pain. 🙏 OMG 😱
I find your story and learning from your story very profound. I can imagine you teaching doctors nurses and people dealing with painful physical conditions to encourage ‘pain metaphor’ learning skills 🙏👍 Thank you for sharing your wisdom