I concluded my last posting stating that there had emerged for me four words/concepts that help me further ‘define’ and ‘clarify’ the concept of ‘Pain.’ Here are the four words that had emerged into my consciousness: Pain, Ache, Agony, and Anguish. Gentle reader I invite you to consider the following:
PAIN = suggests a sudden sharp twinge. This is the Pain I immediately feel when my pain instantly moves from 2 to 8.5. It is like an ice pick has been driven into me at two different locations. This is the ‘Pain’ I currently cope with every 20-40 minutes and it is the ‘Pain’ I will continue to cope with for the next 10-14 days. Yet, as clear as it is this definition does not complete the picture of ‘Pain’ for me.
ACHE = this is a continuous pain – acute, chronic, or dull. For 30 years I have coped with chronic pain that has, with time, become mostly dull pain. At times something will happen and my chronic pain will spike into acute pain. This most recent Pain I am told will not become a chronic pain; I will become pain-free in a few weeks. This most recent Pain, however, is Acute and is, mostly predictable. I know that given a recurring set of circumstances that sometime within a 20-40 minute cycle my pain will quickly move from the 2 to the 8.5 range. It will then remain there for a minute or so and then it will subside and return (as it is now) to the 2 level (or below). So, overall, my pain is ‘continuous’ – the level of pain changes dramatically – and so I can say I have an ‘Aching Pain’ – at times Acute and at times Dull.
AGONY = implies a continuous, scarcely endurable pain. I am not in ‘Agony’ for my acute pain (my 8.5 pain) is not a constant. As I noted, it does appear on a regular basis but it does not linger. During my life-time I have experienced both emotional agony and spiritual agony; I have yet to experience physical or intellectual agony. Because my Pain will come to an end in a few weeks I have not even considered ‘Agony’ as a descriptor of my Pain. However, I do strive to image what my response would be if I were to experience Physical Agony. I also strive to image and feel what others who are in Physical Agony experience.
ANGUISH = suggests long-continued pain plus feelings of hopelessness or despair. When I do not remain focused on the ‘now’ and when I project out two or three more weeks of this type of Pain and when in my less cope-full moments I consider this time-frame to be ‘long’ it is easy for me to experience ‘Anguish.’ At this point I am not ‘hopeless’ nor do I feel ‘despair’ – my current Pain will end (I have had ‘spiritual pain’ that has lasted more than a year and I did experience ‘Anguish’ during this time). By projecting my pain out into the ‘foreseeable future’ I am, however, more aware of what those who are in Physical Anguish are experiencing. In one sense the difference is simple: my Pain will end, theirs will not. Yet this simple insight provides me with an empathy that I did not experience before. For this I am thankful for I hope I will be more in tune with the Physical Anguish of others now that I have a sense of what Physical Anguish entails.
So there you have it, gentle reader. These three postings have helped me understand more clearly what ‘Pain by the Number’ means for me. I leave us with this thought: A prerequisite to empathy is simply paying attention to the person in pain. – Daniel Goleman
Searcher-Seeker 
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