On a medical drama I have been binge-watching the past few nights, a character made a statement that has been revolving in my thoughts ever since:

“Pain is in the body,
but suffering is in the mind.”

Is it truly that starkly divisible? My answer is, I’m not sure; but I think it’s more complex than this. There is a certain truth to it, however.

I have pain almost every day. Sometimes it’s minimal, sometimes it’s intense. This morning I woke up, lowered the footrest on my reclining sofa, and got up to go to the bathroom, and I actually cried all the way there, because the fascia and tendons at the backs and sides of my knee joints hurt so badly when I tried to unfold them that I could barely hobble. The congestion in my legs had kept me awake most of the night (expressing itself through both pain and numbness), and is so intense today that when I tried doing some simple limbering-up exercises while waiting at the stove for my eggs to cook, I had to stop abruptly and sit down.

I have a double challenge every time I get up from the sofa: There is the actual difficulty of rising from a fairly low piece of furniture, and there is the anticipation of pain from doing so. I find myself rocking on the edge for 15 minutes trying to talk myself into it, and then it’s either a surprise, once my brain says “JUST GET UP,” because my legs actually push me upright with minimal trouble, or it’s worse than I could have expected, as it was today. So in that sense, where there is the actual pain and also the anticipated pain, I guess it does split into that mind/body division.

And the bigger question of suffering is bounded by a different level of expectation, as well; the belief that your life and your body will be a certain way, versus the reality of how things are playing out on a daily, physical level. In my dreams, which tend to be vivid and detailed when I actually manage to sleep for a few hours, I am usually around 36 years old and “normal,” which is to say, fit and able to do whatever I call upon my body to do—walk, run, dance, garden, lie down in comfort. Sometimes when I wake up and am in that brief moment of cocooned warmth and relaxation before realization sets in, I completely believe that to be true. I never thought that my fate was to grow up to be an enormous, lumbering, relatively helpless caricature of myself. It’s ironic that I spent most of my life focused on my weight, and now I have been taken down by it (via this condition) in extreme and grotesque ways about which I never could have dreamt. There are days when I feel like such a sideshow freak that I am actually grateful that the exigencies of my physical status keep me confined to the house so that I don’t have to see the looks on the faces of people as I pass among them.

And those thoughts affirm that it’s not all about pain, per se. First of all, there is a difference between pain that is focused in a particular body part regardless of whether it is moving or stationary, sitting or standing or lying down, as, for instance, the pain from an infection or an injury, and the generalized or specific pains that a person suffers as they move around and tax parts of their body that don’t want to do whatever it is that they are being asked to do. Or the random pains, such as sudden twinges and stabs that come seemingly out of nowhere but are actually sourced in a deeper condition.

But what I’m really talking about is something bigger and more amorphous, and the best way I can describe it is a pervasive sense of discomfort, which is overwhelmingly physical, but also overwhelming to the mind. It’s the realization that it doesn’t matter in what attitude you find yourself—sitting at your desk, lying on the bed, walking from one room to another; you feel “wrong” in all those situations. Nothing is causing you a specific pain, but nonetheless you are about as uncomfortable as it is possible to be. It’s caused by this genetic deformity, and it’s expressed in tight tendons and fascia, in massive inflammation in all my joints, in atrophied or unused, unstretched muscles, in congestion due to lack of lymph drainage. It’s caused by chronic exhaustion. It’s a sense of heaviness, combined with a constant twitchiness that won’t let me relax, rest, or even be comfortable for more than a few moments at a time.

But it’s also caused by a state of mind that has been cultivated by a warped concept of being.

It’s the thing that comes between me and life. It’s the depressing belief that I might as well not start a project, whether it’s painting a portrait, writing a story or a blog post, dealing with a week’s worth of mail or a decade’s worth of miscellaneous piles of “stuff,” because I won’t be able to sustain that action or pursue that thought or follow through for more than a few moments or maybe a quarter-hour before losing focus and laying it down. It’s what causes me to spend more and more time on my sofa, mindlessly watching other people’s fictional adventures on my television rather than having my own. And yet I hate that feeling or belief, and do try to fight against it when I am not too exhausted to focus.

Certain things optimistically rise to the surface every once in a while—today, you should get out a putty knife and the jar of joint compound and fill all the nail holes in the hall and bathroom. Today, you should go through the pile of papers on your desk. Today, you should do the dishes that have accumulated over the past three days. Today, you should call the roofer and schedule him to come back to do the other half of the roof before we get to the rainy months. Today, you should make an appointment with your cardiologist to do that test you cancelled seven months ago because your knees hurt too badly that day to go out. But those thoughts usually have to crop up multiple times before either receiving a response or being dismissed, and mostly the actions contained therein never happen.

It’s not like they’re huge accomplishments, but they might as well include flying to the moon for all I am able to achieve them on most days. And this inability eats away at me and causes psychic pain in the same way that the inflammation in my joints causes physical pain.

So where do we stand with that statement that pain is in the body while suffering is in the mind? My conclusion is that the two cohabit in both spaces, fighting for dominance, and both are eating away at my initiative, my optimism, my abilities, and my sense of self.