Recently, I was watching a game on the tube when a Prilosec OTC commercial came on, featuring a portly Larry the Cable Guy (an actual user). As with previous TV spots, he indicated that one Prilosec a day removes all heartburn and “lets me enjoy all the foods I love” (insert grill and fried food) without the pain.
As the commercial ended, a question quickly flashed in my mind. “Instead of taking the daily pill, why wouldn’t he just stop eating the foods that caused recurrent heartburn?” Of course, just as quickly as the question came, answers quickly followed: food tastes really good and provides a quick reward and comfort, everyone else is eating it, it’s cheap, and so on. As the days passed, though, I found myself coming back to this issue. Besides the fact that repeated heartburn might be a sign that more healthy habits are needed, maybe the heartburn is alerting Larry to something else just as important.
A couple of years after I started graduate school, I began to notice some dull discomfort in my knees. Despite playing a variety of sports through high school and into college (intramurals), I had been one of those fortunate souls to not have any knee issues. But as the weeks went by, the aches persisted, and so I finally decided to consult a physician. When the issues arose, my activity was largely confined to periodic cycling and volleyball, with an occasional jog thrown in. After medical testing indicated that nothing was seriously wrong, the orthopedist (who happened to be a trainer for the college athletes) suggested that I look at developing a weight routine that could strengthen the muscles in my legs, especially my quads. Ibuprofen was offered if the pain persisted, but I felt there was much to learn before considering this route. Years later, I would eventually invest a decent amount of money in a leg press machine, which still gets much use in our basement today. Along the way, regular strength training became just part of my typical week.
A few years after, I found myself in my final year of graduate training, as an intern in Louisville. As I detailed in my book “Into the Rising Sun,” I began to experience dizziness, heartburn, and overall fatigue a few months in. Again, I consulted a local physician. Again, I was told that all tests were normal. Medications were offered (both of a physical and psychological variety), and although at some point I took a heartburn med, I eventually had a sense that there was more to learn and I deferred on any drugs. I started to realize that my activity was largely confined to good weather, that my diet was not as healthy as I thought, that my two-a-day Coke habit (free in the lounge) might be a problem. Water became my drink of choice. Slowly, the symptoms started receding and when I ran (as I started to do more), the chest pain that had me thinking about an early grave no longer persisted in the same way. Fast forward to the following year. Our first children (twins) were a couple of months from being born. I was approaching Market Street near the midway point of my first half-marathon. I had felt a twinge of that old chest discomfort that persisted in the first few miles. But as I turned left and headed out towards Forest Park, suddenly I felt the discomfort disappear. I was on my way. Although it would return from time to time in the decade that followed, I effectively left the pain behind that had taught me so much, the pain that I had feared and wished it would go away instantly, but seemed to stick around long enough to make sure the lessons had been learned.
Meanwhile, as I grew stronger and more active, my knees still reminded me that they were there in various ways. But just like the heartburn of old, something curious happened. I began to wonder what they were teaching me, and what there might be to learn. I started to look at ways to grow leaner, to walk, run, bike, and swim more efficiently and ergonomically, to use my body in ways that seemed more consistent with the amazing gift that it was. I added regular stretching to my day, looked at no impact ways to strengthen the muscles and other structures that supported the knee. I discovered the remarkable design of the foot, and how it could be better utilized to handle the impact of running. Soon it moved from an “I” to a “we,” and Amy and I shared in the engaging search to live a healthier, holistic existence. It became the lifestyle that we share today.
Fifteen years ago, I simply wanted to understand what was going on with my knees. I would have never fathomed that sitting here today, I would have been blessed with an Ironman finish, three 50 mile+ runs, a half-day 200 mile bike ride, many century rides, and more endurance events than I can readily remember. Amy just finished her 2nd marathon this past spring and her first half-Ironman last summer. All of this has somehow occurred with kids (now 6) in tow, other than that first unlikely half-marathon back in St. Louis. It has been quite a ride, and even more of a godsend though challenges always persist. But in reflecting on that heartburn commercial, it is clear to me. What I believe is truly a divine gift would likely have not occurred without the promise of one thing: pain.
Equating pain with promise may sound strange, and even uncaring, to all who experience it — especially to a significant, chronic degree. To clarify, I am not minimizing the horror that pain is for millions of people, and the need to provide compassionate care for those whose pain negatively affects their lives. But I firmly believe that for almost all of us, pain is a mechanism that exists for many reasons — it is not something we should necessarily attempt to extinguish without first giving adequate consideration to the messages that it may be sending. Doing so not only further jeopardizes our well-being. It may also prevent us from realizing a richer, more meaningful, grateful course than we ever imagined. It has for me, and I know I am not alone. But if we simply see it as an obstacle to disable, we are missing the promise that it may hold in the heart of its unwelcomed presence.
My knees still bother me today regularly although every time I have consulted my orthopedist about my concerns, I have left feeling very fortunate to have the knees I have. Right now, I have some mild inflammation on my right knee cap that may be a residual from crashing into the pavement after my bike slipped on wet, diagonal railroad tracks years ago. Or it seems that the training for my most recent ultramarathon likely aggravated it, calling for an extended period of more modest miles by foot. I still don’t like the discomfort that presents at times. It would be great to go back to those early years when knees just did their job, and remained silent. But what I have come to know is that although I will probably will never have the exact answer I desire about this joint, the discomfort I feel motivates me to keep learning, keep innovating, and keep pursuing an active existence decades from now. For the first 20+ years of my life, I took my health and movement for granted. Less than a year from 40, I am grateful for it every day. I still don’t like pain. It still makes me nervous about what is to come. But with all apologies to Larry the Cable Guy and Prilosec, I know the answer isn’t just to take a pill. I must be willing to listen to what pain might have to say, if I am to learn to bear what comes my way.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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