I am a senior citizen who experiences pain almost daily, yet I count myself as fortunate and capable. Why fortunate when much in our culture instills fear of increasing misery as we grow older? Why capable when some of the activities I lived for I can no longer do? The compassion and wisdom of my elders when I was a child, combined with some dharma I inherited as an adult, taught me that pain is a part of life, that there’s a difference between pain and suffering, and that knowing that difference can help us make wise choices about spiritual practice and medical care. What I didn’t learn from my elders and the dharma was at what age I would become old and subject to more pain.
I believe I became “old” (notice how you feel about that word) at age fifty-six. Suddenly, I felt exhausted after having had a good night’s sleep, though just days before, I was still jogging three miles, three times a week, and feeling quite youthful. With exhaustion came the emergence of small clear bubbles around the edges of my lips, spreading to my ear. I had no idea what was happening, and that scared me. Soon, I was experiencing excruciating and unrelenting attacking sensations on the right side of my face, including pain in my gums so intense I thought my teeth were falling out and that I was dying.
“I believe the best way to live with pain is to take care of it, unapologetically, but to do so as wisely as possible.”
When I arrived at urgent care, they told me I had that old-age viral infection called shingles. Shingles? Me? That’s when I learned I was old and that my immune system, due to age and having had chickenpox as a child, was compromised without a vaccine. My elders didn’t know shingles would be my wake-up call into my senior years, and ancient Buddhist teachings don’t teach us about the thousands of viral infections that exist, so what are we to do when our biology and physiology indicate a greater propensity for illness and vulnerability to pain? How do we make sense of the threats of diseases while we study and practice the way of nonsuffering?
I surmised that being grounded in the foundations of mindfulness would not be enough to ease shingle pain, so I went to urgent care for relief. I was asked to rate my pain on a scale of zero to ten, with ten being unbearable. After telling them the pain was off the scale, I was offered a few alternatives for pain management. I wanted immediate and strong relief and didn’t once consider possible side effects, so I chose what I was told would be the most powerful pain medication available. It was oxycodone based, and I took it. The year was 2017; I didn’t know how addictive the medication was.
Fortunately, from sixteen years of mindfulness and loving-kindness meditation practices, I knew my “baseline” for feeling the love and kindness that comes from metta practice, so when the medication kicked in and took me beyond my baseline into feelings of an undifferentiated, groundless, and airy kind of pleasant sensation that felt dissociative and gave rise to the desire for more, I switched from oxycodone to an over-the-counter pain medication. I wanted pain relief, but not pain relief that would separate me from reality.
Since having shingles and being scarred by it, I have had other old-age ailments, pain, medication, and surgeries. Still, I feel fortunate and capable. Fortunate because I can offer a “testimony” to recovery, and capable because there are activities I participate in and still enjoy, even though I mourn the loss associated with physical diminishment.
Osteoarthritis in my hips led to another set of choices beginning with physical therapy, then a hip replacement, and more drugs than I’d taken in my entire life. Due to my shingles experience, I was more concerned about the drugs than I was about the surgery, but I wasn’t going to have the surgery without being anesthetized and following the pain relief protocol, at least initially.
The hip replacement was a success, but two days after the surgery, still mentally foggy from the aftereffects of anesthesia and on heavy narcotics for pain, I slipped from the side of my bed and hit my upper body on my bedside table causing a massive tear in my rotator cuff that resulted in another surgery, more pain medication, more physical therapy, and more scars.
Still, I feel fortunate and capable. Fortunate because I didn’t have a head injury, the rotator cuff surgery was a success, and physical therapy is returning some of my abilities. I feel capable because I can still think, write, enjoy being outdoors, and walking. I now know a feeling of liberation and gratitude I never felt before.
I remember the day I was liberated from the clunky sling that supported my rotator cuff healing for six weeks. The first thing I wanted to do after the doctor checked my scars and set me free was hug my spouse fully, for the first time in three months, and when I was able to do so, I cried tears of joy and appreciation. I’ve also learned some valuable lessons about pain and stress management, and how Buddhist practices should not be used as a spiritual bypass for pain management when disease and injury cause significant and protracted unpleasant sensations. So, what use are Buddhist practices for living with the pain of aging if they don’t relieve the pain?
Buddhism, like receiving advice about aging from my elders, is about the wisdom of living a human existence. It is our biological and physiological nature to become ill, grow old, experience pain, grieve, and die. It’s also our emotional and mental nature to experience improved health, vitality, pain relief, creativity, and connection. I believe the best way to live with pain is to take care of it, unapologetically, but to do so as wisely as possible with the advice of our elders and the dharma.
