Everything I Know I’ve Learned From My Bad Back

There are two kinds of people in the world: those who have back
problems and those who don’t. I’m not thrilled to acknowledge that
I date the origin of my own back problems to the period, nine years
ago, when I repeatedly threw my infant daughter up in the air and
carried her around in a Snugli. It’s a dubious etiology, since
another cause would surely have come along soon enough; my back,
one physical therapist has explained to me, was an accident waiting
to happen.

I wish I got to indulge in the luxury of being lionized as Atlas
by my daughter, but I can’t. At parties, I look first for a chair,
since I can’t stand more than a few minutes. I can’t hula-hoop with
my daughter or dance with my wife. I try to jog, but I often get
pins and needles down my right leg. When we take trips my wife has
to carry the heavy luggage; at home, she moves the furniture. Atlas
I ain’t.

You might suspect, I might suspect — my wife definitely
suspects — that maybe I just have a pathetically low pain
threshold. And yet my back doctor assures me that with ‘my back,’
some people play golf and tennis while others have been on
disability for 15 years. I fall somewhere in the middle: I’ve never
missed a day of work due to my back, but I certainly complain about
it a lot. I’m not so much a hypochondriac as a misery miser,
fascinated by dysfunction.

I’m in the awkward position of being exactly half as old as my
father is — I’m 46; he’s 92 — and being in decidedly worse
physical condition. He still swims and jogs and golfs and lifts
weights (sometimes, all on the same day), whereas I’m grateful if I
simply go to bed at night without lower back pain. A couple of
years ago I heard an elderly woman interviewed on This American
say she would welcome entering the kingdom of heaven
because she would finally be granted relief from her incessant
physical pain. While I was listening to this, I was driving, my
back was killing me every time I turned the steering wheel, and I
must admit: I could relate.

Over the past decade, I’ve seen therapists and therapists and
therapists, doctors and doctors and doctors. One doctor said I
should immediately have back surgery — he had an opening later
that afternoon. Another doctor said all I had to do was perform one
particular leg-lift exercise that Swedish nurses did and I’d be
fine. One therapist said I should run more; another said I should
run less. One said that human beings weren’t built to sit as much
as I sit; another said people were never meant to stand upright.
One thought I would need to keep seeing him for years and years;
another criticized me, after a few months, for not cutting the

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.

Now rather than endlessly rehearsing how my life might have been
different, I tell myself about how grateful I am for my life —
with my wife and daughter and our relative health and happiness
together. (Knock on lumbar.) I’m newly in love with my wife —
aware of her weaknesses and completely accepting of them, because
I’m so blisteringly aware of my own. I go to sleep with a night
guard jammed between my teeth and a pillow between my legs. I walk
around with an ice pack stuck in one coat pocket and a baggie of
ibuprofen and muscle relaxants in the other. I’m not exactly king
of the jungle.

I like the humility and gravity and nakedness of this need, for
— and this is apparently a lesson I can’t relearn too many times
— we’re just animals walking the earth for a brief time, a bare
body housed in a mortal cage. My back will always hurt a bit, or
rather the pain will always come and go. But, as my doctor likes to
say, ‘Pain is inevitable; suffering is optional.’

Writer David Shields is the author, most recently, of
Body Politic: The Great American Sports Machine (Random House,
2004). Adapted from
SpineLine (May/June 2002), the
little-known bimonthly trade magazine of the North American Spine
Society (NASS). Subscriptions: $100/yr. (6 issues) from NASS, Dept.
77-6663, Chicago, IL 60678; free for NASS members;

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