Conquering Her World of Pain : A First-Person Account of Six Weeks That Transformed a Victim Into a Survivor

NICK, give mommy a hug,� said my husband, Frank. “Nick, give mommy a hug.�

My son, Nick, was being a temperamental 8-year-old. He sat at the edge of our bed pouting. When he heard his father’s request, he stood up on the bed and began to walk gingerly toward me, picking his way across our legs. He lost his balance, fell forward and threw himself on top of me, wrapping his arms around my body in a loving hug.

Suddenly, I couldn’t move. The fall caught me lying in the wrong position. The impact stunned me. It was as if someone had plunged a steel rod into my lower back. “Something terrible has happened,� I whispered.

I was injured.

Slowly, I began to turn. I sat up. I told everyone it was nothing, just another mild setback. And I wanted to believe what I said, too. I lied to them and I lied to myself. All chronic back sufferers do. We deny our pain. We feel guilty because we look OK, because no one can see where we hurt. There is no crutch, no bandage, no wound.

I was scared. I got dressed carefully. My 3-year-old daughter, Megan, helped me put on my socks and shoes, since I couldn’t bend. I drove to a breakfast meeting at the Beverly Hills Hotel. Half an hour later I excused myself to call my doctor, Robert Watkins. “Don’t worry,� he said. “Just go home and stay in bed for a few days.�

It was like being sentenced to prison. Two years before, when I was carried into his office, Bob Watkins gave me the same advice--stay home for a few weeks. But a disk in my lower back had disintegrated, and no matter how many times I was stretched by a physical therapist or pricked by an acupuncturist, no matter how many painful spinal-nerve blocks I endured, the weeks drew into months and the months became a year.

My back is made of glass.

You can’t imagine what it is like to lie in bed hoping that the next week will bring an end to the pain. You read books at first, like a good soldier who is supposed to catch up on all those best sellers. You promise yourself you will finally write that novel. But then you turn to television. Gary Collins and Phil Donahue became my best friends. The videocassette player became my neighborhood theater.

I couldn’t go through the horror of that isolating ritual again. It wasn’t fair. Hadn’t I just recuperated from a five-hour spinal fusion in which Watkins had rebuilt my back with bones from my legs and hips? Hadn’t I had enough?

I began to fear what was happening to my family. My son was devastated by guilt. My little girl was crying all the time. She wanted me to take her to the park. And what about my husband? How much more could he take? I wondered what would happen to my marriage. I wondered about my career. I felt threatened by other journalists who were whole, who were healthy. One friend tried to reassure me. “Isak Dinesen,� she said, “wrote lying on her living room floor when she had syphilis.� It didn’t make me feel any better. Nothing did.

On Nov. 23, the day after my daughter’s fourth birthday party, the pain was so acute that I was admitted for tests to Centinela Hospital Medical Center in Inglewood. Centinela is known as the hospital for athletes. It was an official Olympics hospital, and my doctor and his associates at Kerlan-Jobe Orthopedic Clinic are the team doctors for the Lakers, Rams, Dodgers, Lazers, Angels and Kings. It was there that I was to learn what the jocks already know--how to survive and thrive in pain.

The next morning, the tests began: a bone scan, a CAT-scan, a myelogram and MRI (magnetic resonance imaging) to photograph the spinal column. They did not hurt. But the Spanish Inquisition would have enjoyed administering an EMG (electromyogram). A neurologist sticks needles into damaged nerves and waits for you to scream when the injured area is penetrated. Three days later, the day before Thanksgiving, Watkins came to my room with the results: The news was bad. Nick’s hug had torn another disk, the one below my spinal fusion.

I was devastated, frantic. “Can you do something?� I pleaded. “Please help me.�

He was straightforward. “You have two choices,� he said. The first one was surgery--but this operation was more dramatic than my fusion; steel rods with hinges and screws would be drilled into the lower part of my spine.

“Oh God,� I begged him. “No, not another surgery.� I didn’t know if I could take it again. The risks are enormous. I might lose all my flexibility, my nerves could be severed. I was afraid I would be paralyzed for life.

Watkins is a Southerner from Memphis. He is a tall, good-looking man who exudes confidence and Southern charm. But this morning, his face was full of pain. He held my hand.

There was one other alternative, he said. It was risky, difficult and agonizingly painful. But it was a chance, perhaps the only chance, to avoid surgery.

“I want you to stay in the hospital for six weeks,� he said. “And go to the pain clinic.�

“Pain clinic?� I had seen ads on television for pain clinics. They were for weak people. People who wanted to dwell on their pain. I had work to do; stories to write. Besides, how could it possibly help me? Watkins urged the more conservative method: “If it doesn’t work, then we’ll have to operate.�

At 10 o’clock Thanksgiving night, my husband, Frank, my two children and a nurse wheeled me on a gurney into my new room in the pain clinic. The pain clinic is a unit within Centinela’s New Directions for Rehabilitation Medicine. My room was a cell. There was hardly space for a sink, a nightstand and a single bed. One visitor meant overcrowding.

For the first time, my husband was more upset than I was. He paced the tiny room. I had never seen him look so sad. What was he going to do without me for six weeks? Once again, he had to be mother and father. He had to do all the scheduling, the driving, the shopping. “Where did you put Megan’s lunch box?� he asked. “And where is the jar of honey?� He had a sore throat. I couldn’t cheer him up. And he couldn’t do the one thing that had always gotten us through a crisis--he couldn’t make me laugh. Megan stood at the door sobbing. Finally, Nick broke the tension. “Mom,� he said, “this place is yucky.�

After they left, I cried. I tried to sleep, tried to forget; but an old man across the hall, who was recovering from a stroke, screamed all night. My anger at him, at my doctor, at the hospital, at life, kept me awake until dawn.

The next morning, at 8, I was awakened by the head of the pain clinic, Dr. Colin Stokol. I was angry. Couldn’t he do something about the screaming?

“Ms. Murphy,� he said, “This is not a hotel. This is a hospital.�

“If it were a hotel,� I snapped, “I would have checked out.�

The remark masked my desperation. Maybe the pain clinic wouldn’t work. A nurse took me to a communal dining room. The walls were beige, with large flowers, and a square table in the center of the room was made of Formica. The air was stale and it was only breakfast time. The other “hotel guests� were there. At first I couldn’t look at them.

A nurse introduced me to some of the other New Directions rehab patients. There was Daisy, a round woman with long red fingernails and a raucous laugh. She was crippled by arthritis. Manny, a tall man, listened to the rock music rolling out of his stereo. He had arthritis, too. Mary stared ahead vacantly. She tried to lift a spoon to her mouth. She was 70, maybe 80 years old, and her hair was white and stringy. She had been paralyzed by a stroke. Anita tried to say hello, but her words were slurred. Her head had been shaved after brain surgery for an aneurysm. Only Cindy was my age. A pretty blonde, she had awakened one morning, walked into the kitchen to make breakfast for her husband and felt strangely ill. By noon she was paralyzed with a rare and mysterious virus, Guillain-Barre syndrome.

What was I doing with all these sick people? They were so much worse off than I was. But in this dining room, I realized that we all had something in common: pain. We were brothers and sisters in agony. I realized with horrifying finality that my life had become unraveled. I began to weep; tears slid down my cheeks. A pretty woman named B.J. put her arms around me. “We all know how you feel, honey,� she said.

I put my head on her shoulder. We both cried.

An hour later, Cathy Lee entered my cell. A compact brunette nurse with a quick grin, she explained the drill. “I will tap on your door every morning at 7 a.m. I expect you to shower, eat, and be dressed by 8:30. I will take you for a walk.� This was no hotel.

Then I met Sid Lindenbaum, my nurse.

“I don’t want you to talk about pain,� he ordered. “I know you have pain--that’s why you’re here. If you want to dwell on it, write it down, but don’t talk to me about it. If you do�--he moved his hands to cover his ears--�I won’t listen. Now I want you to make your bed.� I thought he was joking. He wasn’t. He showed me how to push a button with my foot, raise the bed and fold the covers hospital-style. I whimpered through every motion. As he left the room he added: “I hope you have enough guts to make it through this program.�

I hated Sid.

I began a daily routine. I walked. I sat in occupational therapy. I floated in a warm pool. I worked out in the gym. I was placed under the care of Joseph Chan, a soft-spoken physical therapist who specializes in the spine. His fingertips seemed to have the healing powers of generations.

“It is all a matter of control,� Chan told me. “Do you have control over your life, or does pain control your life? Think of yourself in a war. I will teach you how to fight.�

I began my battle slowly in physical therapy. I held an exercise bar tightly and teetered up to my tiptoes. Slowly, I strained to lift my leg to the side. I laid on my back and gingerly pulled my knee halfway to my chest. Chan held my leg gently and stretched. He monitored every movement.

I looked around the gym at the other troops: Mary sat in a wheelchair straining to stand up by herself. Anita, strapped in a harness, lunged forward, trying to take her first step in months. Daisy slowly pedaled the Exercycle. Cindy lay on a table, trying to roll on her side, with the help of two physical therapists.

Joe Chan taught me about the vicious cycle of pain. The more you have pain, the less you want to move. But the less you move, the weaker the muscles. The weaker the muscles, the more pain you feel. The more pain, the more tension. Tension causes constriction of the blood vessels to the muscles and nerves. The deprivation of blood and oxygen can cause painful muscle spasms. The pain itself creates fear, which leads to more tension and anxiety. The more tension, the more constriction, the more pain, the greater the fear. As the fear escalates, the pain escalates. If you lie down and stay in bed, the muscles atrophy and you become an invalid.

But there is a way to break the cycle: Keep moving no matter how much pain. The process is slow and can only happen through a carefully monitored routine of mental conditioning and physical exercise. I came to think of it as mind-body boot camp.

But what about drugs? At the time, I was getting Demerol shots every four hours. At home, I had refused all painkillers, but in the hospital, they insisted. I was terrified of the drugs. (It is one of the biggest problems for anyone who suffers from chronic pain.) I knew I wouldn’t take any medication when I was discharged. I did not want to spend my life fighting an escalating drug habit, too. But for now, the drugs did what they were created to do: They erased the pain. It was a lot easier trying to fold a sheet or tie a shoelace or stand on your tiptoes on Demerol.

But I still worried about the unexpected.

“Stop anticipating pain,� Sid warned. “Nothing is as critical to breaking the pain cycle as eliminating the fear.� He taught me about endorphins--the body’s natural painkillers, which are released through exercise. He forced me to meditate to the sounds of an electronic wave machine that rumbled like the surf on Maui. Attitude, he said, is the key to victory.

But my attitude was bad. I wanted to stay in my room at night and watch TV. Sid forced me to join the other patients for a card game. I wanted to stay in my room and cry. Sid forced me to join the other patients in coloring angels for the Christmas tree. Sid forced me to take a walk. Sid forced me to help bake an apple cake. I was beginning to think this was like a mental ward. What would be next--basket weaving?

Nothing made sense. Not Sid’s camp-like activities. Not occupational therapy--where I painted little pink and blue bears on a coatrack for my daughter. Not listening to phony waves.

Then I started to get better. I had never tried so hard to heal my own body; I had never pushed through so much physical pain. I was lifting onto my toes 20 times. I was riding the Exercycle for five minutes. As my muscles strengthened and began to better support my back, the doctors withdrew me from Demerol, and I felt it. I had headaches. I was weepy. But I was happy to be off the drugs. Every four hours, Sid would barge into my room: “Time for your medicine,� he’d say. And he would give me a hug. I was so busy that by the end of the third week, my depression lessened.

There was one problem: My son’s guilt intensified. No one could seem to help Nick. Dr. Watkins interceded one afternoon at the hospital. He took Nick on a tour, leading him through the operating and scrub rooms. In one of the operating rooms, he lifted Nicholas onto a table and explained what had happened when he hugged me. It wasn’t Nick’s fault, he said. I could have hurt my back picking up a feather. “Nick, you did your mom a favor,� said Watkins. “Her back is weak. You hit her at just the right time, so she’ll be well enough to come home for Christmas.�

For the first time in months Nick seemed unburdened. He came back to my room beaming and mumbling about what a favor he had done me. His journey toward forgiving himself had begun.

But it was the bond between Frank and me that, like my back, needed the most repair. “Every marriage suffers,� said Joseph Dunn, director of psychological services at Centinela, who coordinates treatment with the pain clinic. Dunn is young and he laughs easily, but he was deadly serious about how chronic pain had affected our home life. He wanted to see Frank and me together. “When pain talks,� he told us, “there is a lot of emotional chaos.� Our first meeting lasted four hours. Pain takes a savage toll. But it was a beginning. All facets of my life were being healed.

And then I sneezed. I was standing in the shower, and I forgot to flex. Pain seared through my back as the tears rushed across my face. I couldn’t move. I hobbled to bed and rang for the nurse. I felt that vise-like grip on my spine. I hurt as much as I had four weeks ago.

Cathy Lee helped me get dressed. She lifted me out of bed and told me she was taking me for a walk. I grabbed the knob on the bathroom door and held tight. “I’m not going,� I said, “I can’t make it.�

I wanted to talk to my husband. I wanted to lie down. I wanted to escape. At noon, I met with the staff of the pain clinic. It seemed to me that nothing had worked. “I’m going to be a vegetable for the rest of my life,� I told them. “I’m going to have to have the surgery.� I felt total despair.

Chan tried to explain that it was typical to have setbacks or recurrences. “Progress is not steady,� he said. “There are going to be bad days.� He didn’t convince me. Only Dr. Watkins could make the final decision: Should I stay--or should I go home?

At 6:30 the next morning, the phone rang. Watkins was calling from Florida, where he was being inducted into the Cervical-Spinal Research Society. Watkins is a distinguished doctor. He flies to Rome to give lectures and treats sports figures such as Rams Coach John Robinson, but he always had time for me and my family. His priorities are with the people who need him. It makes him a unique healer.

“Push through the pain,� he ordered me. “Do not give up.�

I went back to the gym. I climbed one stair. I teetered onto my toes. I pulled one leg to my chest. Joe Chan coached me through five days of hell. The exercise inflamed a nerve that traveled from my spine to my foot. On Friday, the pain in my leg was more severe than it had been in two years. Sid taunted me. He badgered me. Finally, he charged into my room. “Follow me,� he said. He walked me through the cancer ward, then the emergency room. A bloody gunshot victim was rushed by. “Now, do you think you’ve got it so bad?� asked Sid. Finally I had had enough of Sid and the pain.

I decided to fight one more time, and sure enough, by the next week the pain had just about subsided. With it went most of my fear.

Relief from excruciating pain was what I sought, and getting it in six weeks exceeded my grandest hopes. I was discharged from Centinela Hospital--with a $23,000 bill--on Christmas Eve. I have resumed most of my normal activities. I drive a car. I work. I cook dinner. Make beds. I sit through Little League games. I take my little girl to the park.

I still keep up the fight, but the difference is, I don’t talk about it all the time. I Exercycle 20 minutes every day. I walk. I swim. I do stretching exercises for a half hour. And nothing much hurts.

Best of all, I don’t let back pain or the fear of it dominate my life. If someone invites me to dinner, I don’t say, “I’ll have to see how my back feels�--I say yes. I dance. I hike. And if I have pain, I don’t lie in bed. I tell myself--�Don’t worry. It’s nothing serious�--and I mean it.

My reaction to chronic pain has been reprogrammed. Boot camp worked. The people I hated I came to love. I realized that I had never been treated as just the number on my little plastic ID bracelet. I had been cared for in a way that seemed foreign to the cold, impersonal modern hospital setting. The pain clinic not only strengthened my back, it also strengthened my mental resilience to a chronic condition. It retrained my body, my mind and my spirit. I like it this way.