Wednesday, September 1, 2010

Phantom Pain: two theories

Before my surgery many folks warned me about the phantom pains and itches that often follow an amputation. Many medical practitioners also told me about specific techniques (such as an epidural) that can help limit these phantom pains. Many medical practitioners also told me that phantom pains tend to be worse in patients who had pain in the amputated limb prior to the amputation. Since i hadn't had a whole lot of pain in my foot besides the pathological fracture and the incision from the two surgeries, and my docs seemed to know what they were doing, i wasn't too worried about it. I mean, a small incision is nothing compared to having your leg smashed between two cars or blown off by an IED.
Well, i've already shared that the epidural didn't work. Immediately as i realized the epidural wasn't working i began to fear that this meant i would have increased phantom pain. Even as i lay there in the post-op recovery room taking deep breaths between monosyllabic pleas to the nurses to do something, my main thought was, "this is going to make the phantom pains worse, damnit!"

The first week after the surgery i had plenty of phantom itches, but no pain. I could deal with the itches, they were annoying, to have that little itch right there on the side of my pinky toe, but in fact have no toe to itch, but they weren't too bothersome, and most significantly, they weren't painful. I was even happy to tell people, "nope, no phantom pains for me."
But then, during the second week after the surgery they started: short, sharp, and painful. i described some of them to the artist and he did this rendition for me.

Pretty accurate, the only thing he missed was to add a bunch of little devils poking the foot in the flames with sharp tridents. Or my least favorite: the sensation that my big toe is being held in a vice grip and simultaneously hit by a ball peen hammer on one side while being torched with a welders torch on the other. It gets so bad at times i want to just cut my foot off, then i remember they already did.

But the real question remains, how can i feel such vivid, and painful sensations in a foot that is no longer attached to my body? I have two theories.

Theory no. 1: Law of contagion and pathologists at work. The Scottish Anthropologist Sir Richard Frazer, in his influential work The Golden Bough: A Study in Magic and Religion, defined a number of different forms of magic, one of them being the law of contagion. Basically, according to the law of contagion, two things that were once connected retain that connection even after separation and thus have the ability to affect each other (yes, this is the kind of incredible and highly sought after knowledge that a PhD in folklore will provide). An example of this is the popular conception of the "voodoo doll," created by attaching a lock of hair from the person in whose image the doll is created, and thus enabling the holder of the doll to inflict harm on the person by inflicting harm on the doll. So, according to my first theory, the law of contagion is at play here, and even though my right foot has been detached from my body, i did sign a bunch of consent forms saying that it could be used for various studies and research. Big Mistake!! So now my leg is being dissected, cut to pieces, broken apart and examined by a team of pathologists and researchers studying cancer and any other number of who knows what else. The problem is, now that i'm conscious, i feel every one of those cuts, stabs, bone breaks, etc. Every time some researcher deep in a lab in the bowels of the Huntsman Cancer center cuts into my big toe to extract a small sample of tissue to put under the microscope, i feel it. And not only do i feel that, i feel every time that small tissue sample is sliced thinner and thinner in order to get it thin enough to be examined under the microscope. I'm ready to go take my leg back, research be damned!

Theory no. 2: the Torments of Hell. In the New Testament Gospel of Matthew hell is described in the following terms: "The Son of man shall send forth his angels, and they shall gather out of his kingdom all things that offend, and them which do iniquity; And shall cast them into a furnace of fire: there shall be wailing and gnashing of teeth" (Matthew 13:41-42). Now let me clarify, that i've tried to be a pretty good person. I try to treat others with dignity and respect, and although i fall short at times, i do make this a priority. I certainly have my faults and plenty of "sins," but i try to live in a way that honors all of God's creations. Evidently, unbeknownst to me, my right leg did not share these same priorities, in fact, given by the amount of burning sensations i've felt lately, i'd say my right foot led a downright sinful and iniquitous life, and is now paying the price in the "furnace of fire." Unfortunately, the law of contagion applies here as well, and i feel all the sensations—the burning, wailing, and gnashing of teeth—to which my errant foot is being subjected. I'm not quite sure how my right foot managed to carry on so without my knowledge, but alas, it appears my foot is suffering the fate reserved for those in the inner ring of Dante's seventh level of inferno: to reside in a desert of flaming sand with fiery flakes raining from the sky. Of course, this is even more troubling for me since Dante recorded that this level of inferno was reserved for the blasphemers, the sodomites, and the usurers.

Neither of these theories is completely adequate, however. I have to reject Theory No. 1 because the pains persist through the night, and i can't imagine any researcher so committed to her studies that she is up at 2:00 in the morning slicing cell samples from the cancerous growths in the middle of my foot. Nor can i imagine that the Huntsman Center has the funding to run round the clock shifts of cancer researchers. Of course, it's possible that my foot has been parsed and shipped off to researchers around the world, which would help explain the round the clock phantom pains, but this also is highly unlikely.

And i have to reject Theory No. 2 because i just can't imagine how my foot could have been cavorting about, blaspheming, sodomizing, and lending money at absurd interest rates without my knowledge. I mean, i'm a socialist, i don't even have any money. i tend to give stuff away, so where my foot could have even gotten money to lend in the first place is beyond me.

So, in the end, while the phantom pains continue to shoot down my leg with an electrifying and profanity-inducing energy to a foot and toes that don't exist, i have no plausible explanations. Sorry Sir Frazer and Dante. Though your works were highly influential in their respective eras and areas of study, neither has satisfactorily explained the phantom pains that continue to ravage my non-existent limb. Perhaps what i need is just a good foot massage from Beatrice, but i doubt Dante would take too kindly to that.

1 comment:

Megan @ Confessions of a Bake-aholic said...

Matt,
I read this post to Seth on the way home the other night. I love how it was written. We went back and forth between laughing and wanting to cry. Wish your "foot" felt better!