KEEP ON THE SUNNY SIDE

Chronic pain, a magic moment, and a song.

February 2024

Having dealt with chronic pain for over 15 years, I can tell you that it’s easy to begin to feel disheartened most of the time. That doesn’t mean that you can’t experience moments of joy and lots of laughter and fun…I can laugh till my belly hurts with the best of them…but in between those moments it feels exhausting and difficult and generally really frustrating. 
Then, when something comes along that feels like it’s offering you a bit of hope or maybe even a fix, you find yourself alternating between optimism and extreme pessimism, because hey, you’ve been there before, many many times, and nothing has really helped so far in spite of all the promises, but on the other hand, just trying SOMETHING is empowering so let’s give it a shot, shall we? Fingers crossed.

This is where I found myself (again) last week as I drove 2.5 hours to Toronto to visit a pain clinic.  I had asked my walk-in doctor for a referral to this specific pain clinic because it was the only one I could find that aligned with my own years of research on chronic pain and the brain and neural pathways. The director of the clinic was trained in Pain Reprocessing Therapy – a psychological approach to pain similar to what I was studying (but having trouble applying).

I hadn’t even expected to get an appointment – I’d tried several times to contact this clinic in the past, to no avail - and so when the doctor faxed off her referral I thought that might be the end of it.
Two weeks later, however, I received a phone call to book an appointment, and so here I was, driving the long trip to Toronto, not wanting to get my hopes up, but crossing my fingers that I had found a place that wasn’t just going to say “here’s some heavy duty meds”, or “get some surgery”, or “there’s nothing you can do”:  a place that instead could tell me exactly what was causing these issues, rule out things I didn’t need to worry about, and connect me to some neuroplastic-chronic-pain counselling to help me get back on track in dealing psychologically with my body and emotions. (A big ask, but you never know, right??)

Three hours later, having filled out numerous lengthy forms and pain-scales (“On a scale of 1-10, how able are you to go about your daily tasks?”  Um, that depends which tasks. And which day. And what time of day. And what the weather’s like. And how stressed I am.  And it changes by the hour. I’ll give it a 6?”), I found myself in a small office with Dr. A and his intern, Dr. N. 
Dr. A was a solid, friendly man in his 60s, of Persian descent.  An emergency room doctor, family doctor, and sports medicine practitioner, he had an efficient and practical demeanor and got right to business.  His intern sat quietly beside me in a chair, listening.
Dr. A quickly skimmed through my forms and my list of physical ailments.  He asked me to stand, to squat, to lie down and lift one leg up, then the other, then sit so he could test my reflexes with a rubber hammer. The whole thing took about 3 minutes.

Then he sat me down and said that if I’d already tried things like acupuncture and chiropractor and massage and naturopath and I hadn’t found much relief, the next step would be to try medications (which my own doctor could prescribe), and if that didn’t work I could come back and he could give me some lidocaine injections.
To my surprise, it seemed this was the end of the consult.  

I tried to get him to offer some other alternative suggestions.  I asked about Pain Reprocessing Therapy and whether he knew of any counsellors.  “No, sorry,” he replied. “Injections are what we do here. So I can offer those.”
Then he started rambling on (albeit in a very kind and friendly way) about aging and how of course when we exercise or work hard we will have some pain as we get older, and that he gets pain too with certain activities and he has to change how he does them.  And in growing exasperation I thought, “Bloody hell. You must be kidding. If it was just pain from aging and exercising, I would not be here in your office, sir.  I know what that pain is like.  This is not it.  Did I just drive 2.5 hours for nothing? – Help me out here.” 

Rather than give him the finger, which I figured would not help my case, I tried to quickly explain once again how much it was impacting me, how often I get to the end of my rope, how my answers on the pain scale did not perhaps accurately show the extent of my issues, how it’s hard not to be anxious and feel like there’s something really terribly wrong, how isolating it is.
At this point the intern spoke up and suggested some thoughtful and interesting alternative therapies that he had found helpful for fibromyalgia patients, which I was really grateful for.  But is that it?  This is all we’re going to talk about, and now I will drive 2.5 hours home?

And in that moment right there, as I started to gather my things to go, feeling tired and disappointed, the conversation suddenly took a very unexpected turn to the, shall we say, spiritual.  This brusque, efficient, quick-talking emergency room doctor stopped what he was doing, leaned forward, looked me in the eye, and said*, “I promise you that you will be ok. You are strong, healthy, and physically there is nothing really serious or life-threatening that’s wrong.  I know this. I promise you. And life involves a lot of pain and difficulty. It wouldn’t be life otherwise.  We can’t make everything perfect in life, no matter how much we want to, but we can react differently to the challenges.  We think others are doing better than us, but everyone we pass on the street is struggling with pain and hard things and is hiding it.  Some people with diseases feel like they have a new lease on life – and some fall apart.  Different ways of dealing.  Do you believe in frequencies?  In God? And when I say ‘god’ I don’t mean the traditional Christian concept, but energy, life, love, spirit.  I believe there are bigger plans in place for you.  They might be different from the plans you originally had.  You are loved, and love has plans.  You might not be able to do the things you had originally planned in the way that you thought, but you can do something, and that might look different from how you had planned but you will find a way.  What do you want?  Whatever you want, you will find a way to do it, I have no doubt about that.  But we’re not really in control. ‘God’ is. Love is.  Look for the open doors.  There will be open doors…you just need to keep your eyes open for them.  They will lead to new paths.  Be positive. Focus on the good things.  There are always good things to appreciate, even if it’s just one good meal. Life might take a new turn for you.  LOOK FOR THE OPEN DOORS. You will find them.”

(*not his exact words obviously, but I did my best to communicate the gist. Creative license.)

There was a moment of silence.  The intern looked at me and then said with a wink, “Well!  You just got some of that counselling you were looking for.”

I walked out of the clinic, not sure what had just happened and trying to process my thoughts. 
As it turned out, an old friend of mine had just flown back to Toronto - had in fact just landed at the airport - and through a hasty phone call as I was driving we managed to arrange to meet up half an hour later on a patio in Kensington market on the warmest, sunniest February day in history.  As we sat at an outdoor table in t-shirts, soaking up the sun, I told him this story.  And he exclaimed: “It’s like a scene out of the Matrix… they were behaving like a normal clinic, but they were withholding the wisdom of the matrix until they had tested you and established trust, and then all of a sudden he took off his mask and shared with you his true intuition! Like you clearly weren't interested in the blue pill, so that's when he pulled out the red pill.”
And honestly, that IS kind of what it felt like for a brief moment!

It is tempting for me to look at that conversation with the doctor and feel like he was being dismissive and trivializing my pain by telling me to suck it up and look on the bright side.  That sadly happens often in the medical establishment regarding chronic issues. And I did feel that a bit.
And yet…perhaps because it was so unexpected, it also felt like there was something kind of magical in that conversation that my spirit needed.  Perhaps it was because I’ve felt like I’ve been spinning my wheels this year with no plan on the horizon and no clear route ahead and no desire or energy to even do anything.
“There will be open doors if you look for them,” feels promising and hopeful and magical when you’re tired of not seeing the doors.
Maybe he says this to everyone, but it seemed extraordinary, and I can use a bit of extraordinary these days. 
’Extraordinary’ can be enough to give you a sliver of hope.

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NOTE: The whole concept of ‘positive thinking’ is loaded and challenging and confusing, especially for those with chronic pain or illness.  It’s complicated.  The neuroplasticity community seems somewhat divided on it.  Should you try to change all your negative thoughts, or is that just sweeping them under the carpet where they will fester?  Do you instead try to allow all your feelings, no matter how ‘negative’, so they can get out, because your body and spirit are trying to tell you something?  Or will that just pull you down further into the pit of despair?  Is there a middle ground?   Anyone who has studied these approaches to chronic pain will tell you that it is not clear cut at all.

I myself can testify that when people tell me to just ‘cheer up’ or ‘look on the bright side’ or ‘focus on the positive’ it causes me to seethe inside, no matter how well meaning they are. I know they’re trying to help. I don’t hold it against them. But it really doesn’t help me. Neither does pity, or suggestions about what I should do or try (believe me, if you’ve thought of it, I’ve already tried it or researched it).
Distracting me with fun things to do is so much more useful! So is listening.  So are hugs.

But if you’re a middle aged Persian doctor in Toronto who unexpectedly surprises me with a spiritual discussion of these topics, you might just inspire me to look for the open doors.

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This week I created a video of me making music with myself, and ironically the song happened to be “Keep on the Sunny Side”.  I didn’t realize how ironic this was until I’d finished and actually paid attention to the words.  Obviously I don’t agree 100% with the words of the song.  Yet some of it I do.  And I loved the creation process of it…and I love the sound of it…and the music makes me happy. 
So there must be some symbolism in that too, right??!

So here’s a song for you: Arjenna (featuring Arjenna and Arjenna) singing about choosing to be happy, and not really agreeing with that, while actually being in pain and unhappy herself, but ultimately feeling happy about the sound of the song.
It's complicated, folks.