“You know it’s dangerous for someone like you to take opiod medications.”

My head was in my hands as I rocked back and forth in the chair across from the neurologist. “I know, I know…” I moaned, “…but I just can’t keep going like this, I can’t…” The pain this morning had been extremely bad. Tears were threatening to render me unable to speak. I took a deep breath.

“So here’s what we’re going to do,” she continued, writing new prescriptions for much higher doses of my current, non-opiod medications. I had my doubts, but I took them anyway.

“Thank you for fitting me in today,” I said, sincerely, aware that the appointment was now close to over. I had called her office this morning as soon as they turned on the phones, after another hellish early morning wake-up from the relentless burning in my hands, which felt as though they were under a too-hot faucet that wouldn’t stop. An hour before, they had felt as though they were submerged in ice. I could sleep through that. But not the heat. I finally, reluctantly, got out of bed at 4:45, did my morning exercises, made coffee, and waited for the sun to come up. It felt uncomfortably familiar, and a thread of fear wrapped itself around some deep part of my soul.  I resisted the urge to pull it tight.  I pretended that it wasn’t upsetting, how much the dark morning reminded me of when I was still confined to my apartment, writing this blog in predawn hours, in so much pain I could barely even take care of myself.  The kind receptionist had returned my call an hour later to let me know about a cancellation, upon which I pounced.

Now in the exam room in the early afternoon, a cool brightness glowing in from the snow-covered city outside, I looked at the stack of small, pure white, square sheets in my hands.  “So, all these pills – this is just until we figure out where the problem is and treat it, right?”

There was a pause. “Well, I need to tell you,” the neurologist responded, “you’re never going to be completely pain free.”

It wasn’t exactly a surprise. I think I reacted well.  But I discovered that some small part of me had thought, after the second shoulder surgery, that pain free might be an option. That small part of me crumpled right there in her office. Of course I will never be pain free. Of course.

“It’s ok,” I had replied. “I can work with a pain level of 3 or 4. It’s just been getting to 7 or 8 and I can’t compartmentalize it when it’s that bad.”

“Okay. But I just wanted to tell you, there is no treatment that will completely fix this. You’ll always have some pain.”

I nodded to let her know I understood.

And I did. Too well.

But as I walked back out to my car, coat open because I didn’t feel like bothering with the buttons, mostly ignoring the icy wind that whipped through the thin sweater underneath, I realized I had still held out a tiny speck of hope, however pale and fragile, that I would be pain free at some point in the future. The realization that I wouldn’t cut through with a far sharper edge than the wind, leaving bleeding edges on my emotions, already weakened by the lack of sleep. I didn’t want to think it.

I don’t want to think it. The idea that I could be truly well, at some point, eventually, if I just did what the doctors and physical therapists told me, had kept me from slipping into the abyss from which my depression had been tempting me. And the neurologist just snuffed that glimmer out, small candle that it was – as gently as she could, it was true, but it is dark now nonetheless.

It’s what I’ve been begging for, of course, for a doctor to tell me the goddamn truth, for once. But the problem with the truth is that it’s unpredictable, and often unpleasant. Or, in this case, devastating. I will always have pain. I will always take pain medications. My hands will never be as they once were.

I can’t even think about the implications for my work. My blood-drawing accuracy depends on being able to feel veins under the skin. The loss of tactile sensation has meant that I’ve missed every stick I’ve tried in the last week and a half. And now it seems I may not get it back.

I don’t know how I got here. A few months ago this was manageable, an annoyance more than anything. Now it’s frightening, and to some degree, permanent. I want to ask why. I want to scream and rant at a god whose existence I have never been fully convinced of at the top of my lungs. I want to blame someone for this. I want to take it out on them. It’s just too much.

And too little. Pain is invisible. No-one will ever know how bad it is, how hard it is to go about one’s daily business on top of it, to push it aside, to quell the fear that comes with it, to act as though it didn’t exist.

I pause from typing and stretch out my fingers. They look deceptively healthy. Normal sized, and a well-oxygenated, peach-pink color, more red at the tips from the collection of capillaries there. I curl my fingers into my palms and clench them to reassure myself that I still can. Will I get to a point where I can’t? I don’t know. What does partially fixed look like in the current scenario? Will some sensation return along with the lessening of the pain?

The neurologist answered a question I didn’t ask. But there are a dozen others following on its heels. And I may very well not like the answers to any of them, either.