Everything I Know I've Learned From My Bad Back

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I finally saw a back doctor who, unlike 99 percent of doctors I've ever seen, presented himself as a person rather than as an authority figure; ask him how his day is going and he'll say, 'Terrible -- no one's getting better.' He, too, has a bad back, and when he drops his folder, he'll squat down to pick it up, the way back patients are instructed to do, rather than just lean over, the way everyone else does. When I speak to most doctors, I feel slightly (sometimes not so slightly) crazy, whereas I feel like a person, like myself, when I'm talking to this doctor. At my first appointment with him, he emphasized how many of his patients carve their entire identity out of the fact that they're patients; their whole existence is given structure and purpose by the fetishization of their pain, their victimhood. The message was subtle, but I got it: Don't let myself become a suicide bomber.

My doctor recommended that I see a physical therapist named Wolfgang, who goes by the name Wolf and looks and moves in a rather wolflike way as well. One morning when I called to say I felt too bad to come in for my appointment, he said, 'You have to come in; that's what I'm here for,' and he gave me electronic stimulation and a massage. One of my favorite experiences in the physical world is a massage from Wolf. I used to throw my back out completely -- the classic collapse on the sidewalk and yowl to the heavens -- but now, due in large measure to the Wolf program, I seem to have it under control. (Knock on lumbar.) I sit on a one-inch foam wedge on my chair, sleep on my side, on a latex mattress. After lying down, I don't just sit up but rather first 'find my center' (there really is such a thing, I'm pleased to report). During the day, I get up every hour from sitting and do exercises or at least tell myself I do or at least take a hot shower or apply an ice pack or a heat pad. Every day I walk or swim or even, of late, play a little light basketball. Wolf keeps reminding me that neither he nor my doctor has a solution: I have to become my own authority and view recovery as an existential journey.

And what existential journey hasn't been aided by chemistry? I've been in and out of speech therapy all my life, but nothing has mitigated my stuttering as effectively as taking 1 milligram of Alprazolam, a sedative, before giving a public reading. The ibuprofen and muscle relaxants have certainly helped my back, but the antidepressant Paxil has been transformative. At first I strenuously resisted my doctor's prescription. My father has suffered from manic-depression for most of his adult life and his first major breakdown occurred in his mid-40s, but assurances were given that I wasn't being 'secretly' treated for depression or anxiety; Paxil has apparently been used to treat chronic pain for more than a decade. For three months I've been taking one 20-milligram tablet of Paxil a day. I worry a little about becoming a grinning idiot, but I figure I already have the idiocy part down, and I'm so far over on the grouchy side of the continuum that a little grinning isn't going to kill me.

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