Dog Days in Purgatory

Licking my wounds on the front porch

The expression dog days originated in ancient Greece and carried into Roman times. It was derived from Sirius, the brightest star in the constellation Canis Major, (Large Dog) which, in ancient times, rose with the sun during the late summer months and was thus blamed for the long hot days. Given the widespread negative perception of this star, other evils became associated with it throughout the centuries. In 1813, Brady's Clavis Calendria labeled dog days as the time when dogs went mad and man suffered various physical and mental illnesses. Dog days are here as expected in the deep south, but have also landed in all their historical infamy, at my house and appear intent on settling in for the next three months.

Earlier this week I had my first visit with the Ortho Trauma specialist. In addition to the injury directed exam, he was able to review my post injury pre-op X-rays and the post-op studies including all the blood clot stuff done in the ER, which coincidentally covered the same area of interest. After the appropriate greetings and salutations he reared backed and figuratively kicked me the stomach with a force of a Civil War canon. Relatively speaking "The Fall,* as I am now labeling it, was a stubbed toe. The resulting "vertically unstable" pelvic fracture is much more substantial, I learned, and requires three months of  no weight bearing on the right leg BEFORE I can even start rehab. THREE MONTHS. I have subsequently received several thoughtful condolences, all with the consistent message that three months won't be that long. Still stunned and staggering from the abdominal canon shot, I have inwardly countered, "30 minutes doesn't sound that long either, unless someone is holding your freakin head under water, then it's a lifetime."

The fractures do not hurt much unless I move wrong or put weight on the sacrum, both of which are difficult to avoid. But occasionally there is zero discomfort and I consider that the baseline. When the pain comes, its a problem, and this reality has me turned upside down philosophically and professionally. Though not a pain doctor, I do frequently see people in pain, and depending on the location, character, duration, etc, their subjective pain and my objective neurological exam direct me to the source and treatment of the problem. Pain as a diagnostic clue can therefore be of assistance to a clinician, and eventually to the patient, but that same pain is at the initial expense and detriment of the particular patient with respect to their individual comfort and overall well-being.    

Once you are a patient and "see it from the other side," one would think a doc would metamorphose to a kinder/gentler practitioner. My current personal experience, however, is having the opposite effect. While I don't feel humans have evolved to better handle exotic painful diseases, perhaps we have improved when it comes to managing injury. Think how common it must have been for primitive man to break a bone when hunting large animals with stone-age weapons, or fall out of a tree while foraging. Amorous disputes were unlikely settled by 'paper vs rock vs scissors.' Evenings in the cave after a hard day at the office must have looked like the locker room after a hockey game, or the local French ER during the fast, crowded, crashing stages of the Tour de France. I doubt anyone received Dilaudid . Folks back then had little choice other than deal with the pain and alter their activities accordingly.

Perhaps to alleviate the anxiety associated with the discomfort, I have convinced myself that I will get better faster and more thoroughly if I, in harmony with my primitive ancestors, just deal with it rather than take any pain meds. I'm on day four of my inner caveman. This new philosophy blends well with my early religious beliefs. Raised in a traditional and enthusiastic Catholic home with 12 years of formal Catholic education, I summarily dismissed much of the Church's teachings before I was 10 years old. I apologize if I have offended anyone, and will only likely make it worse defending each of my positions but I feel compelled to mention one. Not only did I think the infallibility of the Pope was ludicrous, once exposed the absurdities of their individual actions throughout my favorite time in history, the middle ages, (where some might say I belong) I think the current Pope should be tried at the Hague for Crimes Against Humanity. Charges based on his roll in the systemic Church supported child molestation epidemic while a Cardinal, as well as his current positions on birth control and HIV prevention in third world countries, are all qualifying crimes in my book.

The one teaching I absolutely did love as a child, and more so as a an adult, especially since I learned the Church has dumped their belief on the issue, is that of  Purgatory. Rarely a day passed without my mother telling one us four kids, while we were whining over some pain or seemingly serious injustice, "offer it up for the poor souls in Purgatory." The only statement I heard more often was " I'm going to kill you if you don't stop doing that." For you non Catholics, a quick lesson. We were taught that when you die, you went to either heaven or hell depending on a few easy to follow guidelines that any semi-competent mid-level bureaucrat could grasp. No need for St. Peter or God to get involved. If your case did not fall into one of these two choices, you roasted in Purgatory for awhile to atone for your minor sins and then on to heaven. Living people could cut your sentence by donating their suffering on earth for the deceased in purgatory.


The most attractive angle of this concept was that it made sufferings a relative zero sum game.  Pure zero sum delegates a winner and a loser, no in betweens - your loss is someone else's gain, like betting through Vegas on the Superbowl. Relative zero sum is more common, like the stock market, with money being split between the investor and the broker, though theoretically you and the broker could keep winning mutually. Zero sum in economics, mildly interesting. Zero sum for suffering, I LOVE IT. I loved it as kid, love it more now, and anticipate loving it even more in the future.


So what does all this really have to do with pain?  Like most things in my life, it comes back to bicycling, and more specifically, the type of bicycling I most enjoy- hunkered down on the bars, big gear going, mailboxes and telephones poles flying by like strobe-lights type bicycling. Yes, "hammering" for selected believers. When riding this hard an inner voice shouts, "This hurts, this hurts." Trying to simply ignore or tolerate the voice is the wrong manuever- you've got to embrace it. If you press on through, the words evolve subtly yet significantly: "Yes this hurts all right, it hurts so good!" 

 *Likely to be eventually called "The Fall From Grace" if you are wondering which way this blog is going.