Lying on a gurney in the middle of a chaotic emergency room provides one with ample time for self-reflection. Somehow, despite all of my precautionary measures to avoid a fall, I stumbled and sprained my foot for the second time in 18 months. A few hours later, I was watching a flustered intern chase an inebriated elderly patient around the ER.

In the entirety of the human experience, pain is a profound one, a unique double-edged sword. We inherently need pain to signal danger, damage or any other distress we might encounter. It acts like a physical conscience, noting what is right and wrong for the body to do. Who knows what kind of residual damage I could have done to the tiny bones and ligaments below my right ankle had I simply ignored that initial sharp pain. Because of pain, one immediately pulls back one’s hand upon touching a flame, even before the concept of the flame is fully processed. Evolution developed this primary reflex to get the body out of harm’s way instantaneously — the signal is so fast that it goes to the spinal cord before even relaying to the brain.

When the signal does finally get to the brain several milliseconds later, pain reveals its other, much more complicated face. The complexity of this secondary pain derives from the many pathways in the brain that connect functional domains like the emotional centers in the amygdala and insula, or the prefrontal cortex, which generates expectations. To make matters even more complex, every person’s brain works differently, and subtle idiosyncrasies in these connections can yield completely different perceptions and meanings of the same pain-inducing stimulus.  Pain can often be chronic and so deep-seated that it is literally unbearable for an individual to withstand. Yet while this intense pain can make one person suicidal, another simply endures it without complaint.

However, I’ve never experienced the kind of pain that hurts that deeply. The dull soreness that I feel in my feet every day, even without exacerbation from injury, is trivial compared with what I could feel. Habituation to pain has a lot to do with my perception of it: my arch-less feet are structurally not ideal to handle my naturally klutzy behavior, but I’ve gotten used to it. I cope with my pain by simply not thinking too much about it. Of course, not everyone deals with the same pain I do.

On college campuses across the country, pain is ubiquitous. I might twist my foot occasionally, but student athletes constantly deal with far more serious sports injuries. A crazy Saturday night mixed with a couple of poor decisions could result in a bad hangover or broken bones. A 2008 Boston University study found that 85 percent of American university students report “back-related pain and discomfort;” heavy, textbook-laden bags and perpetual craning toward computer screens will make for some serious chronic back pain. All of this pain is physical and is attributable to some specific cause.

Yet, other pain is not so simple. Students encounter many emotional pains, from experiencing a bad breakup or one-night stand to failing a test or class. Deeper psychological pains that often cannot be tied to anything specific (e.g. long-term depression, eating disorders, et cetera) are also not uncommon on campuses.

The need to cope makes us care about pain; after all, if it didn’t hurt, why would we change anything? Unfortunately, our coping mechanism of choice is usually escapism simply because it is easiest. On college campuses, this escapism usually takes the form of alcohol or other drug consumption. Once sober, though, the student still carries around the same pain, sometimes in addition to intoxication’s many side effects.

In dealing with pain, it is important to remember that the actual experience of pain is tied to the anticipation or expectation of it. The placebo effect highlights how powerful thinking about pain really is: If one believes he or she is being treated for pain, he or she will actually experience less pain. Perception of chronic pain is based on one’s long-term memory of the pain. In a December 2010 study, researchers from the University of Toronto and Seoul National University found that inhibiting PKM, a protein that modulates long-term memory, alleviated chronic pain in one region of the brain. Thinking about past pain definitely doesn’t help alleviate current pain.

After I had waited in the ER for so long that people-watching had become boring, my doctor returned to tell me that, no, I had not broken any bones in my moment of clumsiness. He said I should bear weight on the foot only to the extent I could tolerate. I definitely could not tolerate that sharp, shooting pain. So I chose to use crutches, because dealing with pain is tricky — even when the double-edged sword is spinning, you have to know which side is facing you.

 

Caitlin Gilbert is a sophomore in the College. She can be reached at cgilbert@thehoya.com. The Cortext appears every other Tuesday.

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