A slow grey manatee just hanging still in blue water Photo by Maegan Luckiesh on Unsplash

In “The Proper Means of Regulating Sorrow” Samuel Johnson wrote that although most human needs have a theoretical solution—the miser could perhaps gain more money, the glutton more food—for the sorrow of grief:

there is no remedy provided by nature; it is often occasioned by accidents irreparable, and dwells upon objects that have lost or changed their existence; it requires what it cannot hope, that the laws of the universe should be repealed; that the dead should return, or the past should be recalled.

Nerve pain is like that. There is no remedy. It can be dulled with drugs like alcohol and opiates—which don’t actually reduce nerve pain much, though they certainly make the sufferer care about it less—or treated with an anticonvulsant like pregabalin that reduces pain signals. The problem is, pregabalin also reduces other nerve signals. Some people seem to have a reasonable tolerance to it; I do not. Pregabalin, even in small doses, makes me feel like a manatee: grey, blimp-like, and drifting through a dreamy liquid world. Everything requires an enormous effort.

In September I had a pseudo-relapse of my MS. Pseudo-relapse is helpfully explained by International Multiple Sclerosis Management Practice:

Another way MS patients can experience worsening is called a pseudo-relapse. When physicians use this term, we are also referring to worsened neurologic symptoms; however the underlying cause of the worsening is not from new immune system activity or inflammation, but rather from the damage that has occurred from previous inflammation. […] There are a number of stressors that can affect the body and MS in this manner.

My pseudo-relapse was caused by physical inflammation—the truly awful wildfires and smoke that, for 10 days, turned Seattle’s air quality, along with Portland’s, into the worst in the world; plus writing every single day without a break for months—and emotional stress: politics, protest, and pandemic. Also overwork—writing every day, flat out, seven days a week for months. My symptoms were a recurrence of the terrible nerve pain I had six years ago—only, thankfully, instead of the entire left half of my body, it was part of the upper left quadrant: neck, shoulder, a bit of my chest, arm, and hand. And instead of constant, sheeting pain, it was only when I moved. Basically, my pain-gating held—so it wasn’t as bad.

But it was still, y’know, a lot. Bad enough that I needed biggish doses of pregabalin; I turned into a manatee.

Manatees are not known for much more than drifting about looking grey; they’re certainly not known for their writing talents. It could be their lack of thumbs, but also it turns out it’s very difficult to focus on words when drifting about in a hazy world; being in pain; and watching the world burn, literally and figuratively. So while on pregabalin I watched hours of TV, and fell asleep a lot. I did still manage to work, just very…slowly. (Without the pseudo-relapse I would have been done with Menewood long before Halloween.) But then the rain came, the wildfires died down, and gradually my inflammation eased. My pain began to lessen. I could reduce the dosage; I began to wake up. Then one day I realised I had had no pain at all for 24 hours; it was over. I swore I would be grateful for the rest of my life for every single day without pain.

The funny thing about pain, though, is that we forget. As the days pass our minds close seamlessly over the horror and it fades. We can remember that it happened but we don’t feel the memory. I’m guessing this is a necessary evolutionary adaptation. After all, what woman in her right mind would ever go through childbirth twice if the pain wasn’t swaddled in gauze and sprinkled with glitter then safely tucked away somewhere inaccessible? And so it was with me. I wake up in the morning and forget to be grateful for lack of pain. I’m grateful for many other things of course—delighted and grateful every day for sunshine, kitties, Kelley, a roof over my head, hot tea, tasty coffee, cold beer, fabulous cocktails, and a thousand and one other things.

So while sorrow and pain might have no immediate remedy, if we’re lucky they both eventually fade. I am glad. May this be true for you, too.