Sometimes the worst thing about having chronic pain is the feeling that no one believes in your condition. People can be like the Black Knight and tell you that "tis only a scratch." How do you make them aware of your new normal. 

Last weekend I went to see my niece in her high school production of Spamalot. They did an amazing job.

My favorite scene was the one with the Black Knight. You’ve probably seen it. The Black Knight challenges King Arthur to a duel. During the duel, King Arthur cuts off the Knight's arm. When King Arthur suggests they stop fighting, the Black Knight says, “tis only a flesh wound.” King Arthur looks at him in disbelief. The Black Knight urges King Arthur to keep fighting; so he does. As each of the Knight’s limbs are removed, the Knight argues against the reality of what is happening to him. Finally, King Arthur leaves the Knight limbless in the middle of the forest.

As I watched the scene, I thought about my patients. In many ways, chronic pain patients are like King Arthur. The reality is that they have chronic pain; they know they have it, but others often deny it. For chronic pain sufferers, the people around them are often like the Black Knight. They deny the chronic pain patient's reality. They argue that because they perceive the chronic pain sufferer as normal, they must be normal.

The separation between the way chronic pain sufferers perceive their world and they way others perceive chronic pain sufferers was brought home for me even more when I heard a chronic pain patient refer to non pain sufferers as “the normals.” According to this individual, the normals didn’t understand that although she was smiling and laughing, her reality was constant pain. In fact, her friends and relatives would sometimes deny the reality of her pain based on her smile. Their disbelief in her pain made her feel worse.

Of course, in one way her friends and relatives were right. After a while, for a chronic pain sufferer, pain becomes the new normal.

As someone without constant pain, I know that I can’t understand exactly what someone else is feeling. It’s impossible to enter into another’s experience of pain. And here is my dirty little secret — I don’t really want to. Who would? So I urge my pain patients and their caretakers and friends to enter into a conversation about the new normal. Talk to each other about what reality is like for you. Don’t let yourself be like the Black Knight isolated, and cut off from everyone else.

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