I May Not Look Like I’m in Pain – But I Am
/By Crystal Lindell
When my mom had a sudden perforated ulcer in her stomach in 2022, she fell to the ground at work and was taken to the hospital via ambulance. While waiting in the ER, she alternated between the floor and the bed in eerie silence.
She didn’t scream, she didn’t cry. She just stayed quiet while waiting for help.
My mom had been dealing with a very bad hip for years, so extreme pain wasn’t new to her, and she had long ago trained her mind and body to stay calm when she was in pain.
However, because she wasn’t screaming at the top of her lungs, all the nurses assumed she was fine.
It took the staff 9 hours to finally order a cat scan, which showed the hole in her stomach. They immediately rushed her into emergency surgery, which barely saved her life.
Perhaps I inherited some of that ability to be quiet anytime my pain flares up. But I think it’s more likely that I learned what anyone who’s dealt with pain for long periods of time knows: The worst thing you can do is scream.
That does not align with the common media portrayal of pain though. In movies and TV shows, extreme pain involves obscene levels of screaming, buckets of tears, and facial expressions that actually match the number 10 emoji on the pain scale.
The patient we see in the media always has the vibe of a screeching red fire alarm.
In real life though, that’s not what extreme pain always looks like – at least not for chronic pain patients.
In real life, deep, unrelenting pain often arrives with a scary level of calmness, an odd silence, and maybe – on the especially bad days – a few quiet tears streaming down the face.
Unfortunately, this disconnect between how pain is portrayed vs. what it actually looks like can lead to some very upsetting consequences. If you’re not screaming at the top of your lungs when you’re in pain, then everyone assumes you must be faking it.
By everyone, I don’t just mean friends and family – I also mean important people like bosses, clients, and even doctors.
There are two main reasons why living with chronic pain usually changes how you react to level 11 pain flares.
One, you realize pretty quickly that staying calm is the best way to keep the pain from escalating even higher.
And two, our vocal chords just aren’t designed to scream at full volume for very long.
Even though I have some days where the pain drops down to as low as a 2 or a 3, I spend most days trying to keep level 7-9 pain from ruining my life.
I take multiple substances to try to accomplish that, but still spend lots of time coping with pain levels that healthy people would probably go to the ER for.
The reality is that it just isn’t physically possible for me to scream at the top of my lungs until the pain subsides. It would be like having the fire alarm go off every single day.
Eventually, you realize that the only thing the alarm was doing was making things worse.
All this means that most of the time, you aren’t able to tell if someone is in pain just by looking at them. In fact, it’s the people in the most pain who are often the best at hiding it.
As such, the best way to handle the situation as an outsider is this: If someone tells you they are in pain, believe them.
It really is that simple.
