The Pathophysiology of “Hurt”

I’m taking a class called Advanced Pathophysiology right now in my nursing program. It’s a Masters level class with 44 students and, kids, it’s a bugger. In those higher level classes, you’re assigned like 300 pages a week to read and digest, with a test every week just to make sure you’re on track.

I love it, actually. I really like learning and seeing how this is connected to that and therefore, when this part gets screwed up, this is what happens, and furthermore, this, this, this, and this result as the whole mess goes on down the line.

The idea is that, as a nurse practitioner, I will be equipped to determine why what I’m seeing is occurring – what’s happening under all that skin – and more importantly, what’s bound to happen next if we don’t do something and the best way to restore equilibrium and health.

So. There. I like it. And I think I can be forgiven if I say that that kind of thinking now consumes me. I tend to see everything in terms of chain reactions and cascades.

Like “hurt”, for instance.

Let’s say something happens in my life. A stimulus. An injury. Not a “well, that’s annoying” thing. More like a “came-out-of-the-blue-didn’t-see-that-one-coming” event that pushes everything else out of the spotlight and leaves me standing there, howling and keening in utter pain.

That happens. This is life, right?

So we have this life-altering injury in our lives. Before we even realize it, responses are set in motion to defend our minds against this awful pain. Because otherwise, clearly, we’d lose our damn minds.

One response – we’ll call it the emotional inflammatory response. In our bodies, defenders are mobilized before we even realize it, and in our minds, I think the same thing happens.

Anger, of course, are our emotional white blood cells. Anger rushes in and gives us strength when, otherwise, we would collapse into a moaning, blithering heap. Yay for anger.

Then, as the cerebrum kicks in (that’s our rational thought for you non-nursing folk), and we add blame to the mix. It’s the reason why every single time I lose a patient I love, I predictably get mad at God. (Don’t worry about it. God is big and used to my childish histrionics – He ain’t stuttin’ me, as we say in my family.)

The enemy needs a face, even when there really isn’t one sometimes. Even when the face is most appropriately ours, because let’s face it, we do stupid things that cause ourselves pain sometimes. (Or is that just me?)

So – blah blah blah – we go through these processes. Throw in a few complementary responses including guilt, rationalizing. They manifest themselves when we do things like repeat our tale to everyone we know because we need someone to hear us, to know how bad we’re hurting, and to do something, damnit!

And then, if we have a healthy emotional immune system, we move onto into thinking about the hurt, and the pain more rationally, deciding how we will integrate that into our lives (because the most beautiful lives have shadows and tints of pain staining them at some point), and we think things through.

That’s the healthy response.

But sometimes, because we aren’t so healthy to begin with, we get stuck in those initial inflammatory responses of anger, wailing, blame, and guilt. Women, especially, seem to feel a need to do something. Like dye our hair platinum blonde when clearly, that’s the dumbest and least appropriate hair color for us. (Oh wait – is that just me?)

Anger, blame and guilt serve the useful purposes of giving us energy and distracting us from the pain for the moment, but they aren’t meant to continue indefinitely, anymore than our bodies want to have a flood of inflammatory response going on constantly.

In our bodies, when it does, you get a bunch of catabolic processes and autoimmune disorders. Basically, our bodies start to eat itself.

I’ve seen the same thing happen emotionally in people. They become stuck in their own history of hurts incurred years – decades! – before. They run themselves around that mulberry bush of anger, blame and guilt – which was perfectly normal and understandable initially – until it takes on a life of its own and starts eating them.

My advice, if you find yourself stuck there?

Cry. Cry as loudly and as long as you want, because real, gut-busting weeping is a self-limiting thing. It wears you out, you eventually fall asleep and somehow, while you’re sleeping, a little bit of healing takes place.

You may have to do it again and again. But each time, you gain a little more strength – even when it leaves you feeling like a limp dish rag.

And that, my darlings, is what I’ve done with my expensive education this week!

Yay me!