The Pain Scale


Where do you rate your migraine, back pain, abdominal pain? A two, a five, a ten?

A few weeks ago I went to see my physical therapist for hip pain. “On a scale of zero to ten, ten sending you to the emergency room, how bad is your pain?” she asked. Pain is universal, and, like most of us, I’ve been asked to choose a number from the pain scale time and again: in the weeks and months after my pelvis, foot, ribs, and lower back fractured in a car accident, when my bowel got all tied up in a knot, and when a cyst on my ovary ruptured.

In 1999, the Veterans Administration established pain as the fifth vital sign, requiring medical professionals to assess pain using the pain scale, a practice introduced by hospice in the 1970s. But how accurate is that scale? While one’s heart rate, blood pressure, and temperature can be objectively measured, pain is subjective. It’s based on perception, which is influenced by a whole host of factors: attitude, stress, culture, upbringing, age, gender, and more. One’s five may be another’s eight. And what about all the fractions in between two whole numbers? Couldn’t one’s pain be a five and two-thirds? What about chronic pain? Doesn’t that change our perception of overall pain? Are you more apt to assign an eight to, say, your recent foot pain because you’re sick and tired of the pain? Or are you more likely to give that toe, say, a three because you’ve become used to pain and can no longer decipher a three from a four or an eight?

I’ve never met anyone who said they’ve never felt physical pain. There are too many opportunities: paper cuts, stubbed toes, headaches, toothaches, back and neck aches. Why is there a zero on the pain scale anyway? It seems useless. As Eula Biss says in her essay “The Pain Scale,”  “Zero doesn’t behave like other numbers.” When we count, we don’t start with zero: “Zero, one, two, three.” Zero is merely a placeholder, a midway point between one and minus one, for instance.

Because I’m not good at making decisions, I’m not partial to the pain scale.

I think pain is best described with real life descriptors: throbbing, stabbing, crushing, needling, nauseating, a quadruple knot in the gut, the hottest part of a fire, a butcher knife to the toe. I want to tear apart my skin and crawl out of my body. I want to scream, scream, scream.

If you were asked to describe your pain, past or present, what would you say?

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“Melissa’s memoir will be very well received as a true work of literature.” ~ Patrick Ross

Award-winning writer and author of Committed: A Memoir of the Artist’s Road.

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When in 2003 an elderly driver plowed into a busy Santa Monica farmers’ market, 36-year-old Melissa Cronin’s life was shattered in an instant. In her riveting memoir, Cronin takes us through her journey of recovery as she slowly rebuilds her life anew. Writing with the expert eye of a medical professional, Cronin’s prose is at times tender, funny, lyrical, and always painstakingly honest. [Her Memoir] will astonish readers with a reminder of our human resilience and the power of story in our precarious lives.“
∼ Alexis Lathem 

Award-winning poet, journalist, and writing instructor.

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“Melissa writes with surety and much fine purpose. She [has] found the perfect structure for her memoir as well as a compelling voice with which, she, as a narrator, [has] turned life into art.” ~Sue William Silverman

Award winning author of the memoirs The Pat Boone Fan Club: My Life as a White Anglo-Saxon Jew, Love Sick: One Woman’s Journey through Sexual Addiction, Because I remember Terror, Father, I Remember You, and Fearless Confessions: A Writer’s Guide to Memoir.

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“[Melissa’s] memoir is one of the most compelling projects I have come across during my tenure at Vermont College of Fine Arts.” ~ Rigoberto Gonzalez

Author of Butterfly Boy: Memories of a Chicano Mariposa, winner of the American Book Award from the Before Columbus Foundation.

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“[Melissa’s] memoir leans on the experience of others, as well as lyricism and painterly images.” ~ Sascha Feinstein

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“A riveting account of survival and determination, told with clarity and honesty.”
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