My story differs from alto’s only slightly. For years doctors told me: Rate your pain on a scale of 1–10.

But what the hell did that mean? I studied philosophy in college, and dated psych students. I understood the concept of gestalt and long pondered questions such as, “how green is green?” I understood what Karl Popper meant when he suggested, “X is X if and only if X truly is X.”(I think it was Popper. It might have been Toulmin. Graduate school was years ago.)*

Having slaked my thirst at the fountain of the Positivists I suffered reversal like Wittgenstein. Language had indeed become a game, only I no longer knew the rules.

So when doctors asked me to rate my pain on a scale of 1–10 how did I know my 1o wasn’t the equivalent of their 5? It’s not like they ever gave me a chart: Wasp sting = 2, Scorpion = 3. Broken leg=6. Arm sawed off and spouting blood = 7. Child Birth = 1o (Men need not apply).

Nor had I experienced any pain greater than a scorpion sting.

The practical experience of pain

Thus, after a colonoscopy I was told to call my doctor if I experienced any pain. The following morning, I experienced pain in back, behind my abdomen, in the area of the colonoscopy.

Unfortunately, the colonoscopy was performed on a Friday afternoon, forcing me to call the after hours clinic. I called and they asked me, “Rate the pain on a scale of 1–10.”

“How the hell should I know?” I said. “I’ve never had this kind of pain before. But it’s the worst I ever had.” Forced to ballpark it, I said five.

“If the pain gets worse, go to the emergency ward.”

I replied that my doctor told me to call them, and they said they weren’t equipped to help me.

The pain got worse within thirty minutes, so we drove to the emergency clinic (which was fortunately around the corner). Still thinking the problem was related to my colonoscopy we gave them my doctor’s number and the admitting nurse’s only concern was, “Rate the pain on a scale of 1 to 10.”

“How the hell should I know?” I replied. “Nothing’s ever hurt this bad before?”

“Ballpark it.”

“What’s the ballpark?”

“One being an ant bite, ten being a kidney stone.”

That really helped. “I’ve never had a kidney stone. All I know is it’s the worst possible pain I can imagine.”

Given the kidney stone baseline, however, and thinking my pain couln’t possibly be that bad, I ball parked a six.

They stuck me in the waiting room for four hours. Within an hour I was bent over clutching my gut and groaning. Two hours later I couldn’t sit still. Three hours later I was visibly crying from the pain. Finally my wife grabbed a nurse and it took yet another hour before they had me under an MRI.

“Guess what?” the nurse announced. “You have a kidney stone.”

It took two shots of Darvoset and three Hydrocodone pills to bring the pain to manageable levels. Two days later, I evacuated the little bastard. I still have a photo of him (which I enlarged in Photoshop to give a more dramatic appearance).

Image for post
Image for post

(Okay, this isn’t my kidney stone. The lab technician lost him. I never forgave her. I found this stone on the Internet and Photoshopped him for a Facebook post)

He was merely my first. The second came in spite of a year’s worth of visits to a urologist, but this time I was prepared. As soon as I felt movement, I called my doctor for a prescription of pain killers and we parted ways relatively painlessly.

The lesson I learned?

Wittgenstein was right. Language is a game.

And I intend to win.

Doctors do have pain scales. For instance, if you hurt badly enough to make you groan or vocalize in any way? It’s a four. That’s pretty low on the scale. Don’t let them intimidate you into lowering your pain threshold.

In the future, if they ask me to rate my pain on a scale of 1 to 1o, and I want painkillers, my answer will be “11.”


*In retrospect, my favorite lesson from college is the moment when my phenomenology professor, Donald Driesbach, when confronted by a student convinced he found an insurmountable contradiction between two Platonic dialogues, answered simply, “Plato forgot.” The other students mocked Driesbach for his facile response. I finally, after years of struggling with the concept of truth, embraced the moment. Only weeks before I stumbled across Emerson’s quip, “Consistency is the hobgoblin of little minds.”

The epiphany merely confirmed its value over the years since. We may approach some data that confirms long-held suspicions, but as soon as we try to nail “truth” down, we find ourselves circling the drain.

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Living metaphor. Follow me @stephens_pt.

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