On a Scale from 1 to 10: Life Writing and Lyrical Pain

Susannah B. Mintz

Journal of Literary & Cultural Disability Studies, Volume 5, Number 3, 2011,

pp. 243-259 (Article)

Published by Liverpool University Press

For additional information about this article

https://muse.jhu.edu/article/448704

[ Access provided at 9 Feb 2022 09:50 GMT from Indian Institute of Technology Tirupati ]
On a Scale from 1 to 10
Life Writing and Lyrical Pain

Susannah B. Mintz
Skidmore College, Saratoga Springs, New York

Given the notorious resistance of physical pain to textual representation, how does an author
write the story of pain? Using Eula Biss’s 2005 essay “The Pain Scale” as its touchstone, the article
considers lyric essay as pain’s most suitable autobiographical genre. A lyric essay, it is argued,
can perform the kind of conceptual shift that many theorists of pain have called for, situating
pain along the pathways not just of nerves but of subjectivity, of relationships between self and
other, imagination and words. By turns elusive, imagistic, ecstatic, associative, and melodic, more
often circling and symbolizing life events than narrating them in linear ways, the lyric essay has a
unique capacity to represent the self-in-pain, giving pain a rich experiential dimensionality that
it may lack in more conventional, particularly medical, accounts. In “The Pain Scale,” Biss does
not render pain as an adjunct to other physical experiences, such as addiction or disease, but
rather capitalizes on the distinctive fragmentation and emotional intensity of the lyrical essay
to capture the movement of pain. In a form where pain becomes affirming rather than negating,
an avowal of the self’s aliveness and of its impact on the world, new articulations can occur—
of how we conceive of, and therefore live, with pain.

The body in pain, Elaine Scarry famously contended in 1985, is unrepresentable.

Resistant to any scale of measurement other than a subjective one, pain is at
once inescapably real to the sufferer and invisible, even unreal, to the obser-
ver. The person in pain, wanting nothing more than alleviation, can speak of
little else but pain, yet pain notoriously eludes description, defying our efforts
to articulate its myriad sensations. Pain reduces everything to itself, dominat-
ing consciousness in a way that seems to collapse identity into the maddening
persistence of discomfort, but is at the same time experienced as a frighten-
ingly alien presence within, its source—if one can be determined—subject to
fantasies of battle, excision, or cure. We are, as students of memory, subjectivity,
and life writing have shown, driven to narrate ourselves in the form of story
with recognizable structures and point, yet pain interrupts the plot, makes us
unrecognizable to ourselves, shifting our habits of being to accommodate it.
How, then, do we write our stories of the fact of pain when pain can only be
told through metaphor, association, and complaint, rhetorical strategies with
tenuous authority?
If “pain is a scandal,” as David B. Morris has said (71), it would seem a read-
ily available, even marketable, subject for autobiographical writing, especially
Journal of Literary & Cultural Disability Studies  5.3 (2011), 243–260 ©  Liverpool University Press
ISSN 1757-6458 (print)  1757-6466 (online) doi:10.3828/jlcds.2011.21
244 Susannah B. Mintz

in this moment of memoir. It is no longer news that many authors enter into
print for the first time through some form of life writing, or that many of those
narratives foreground experiences of disability and illness. Ours is a culture
greedy for tales of the tawdry and the traumatic, and also for the promise of
rehabilitation, transformation, restoration—for a narrative arc, in other words,
that climaxes and resolves. If pain disturbs the forward motion of a life story, it
might also be said to pursue its own narrative trajectory: it begins, it worsens, it
abates; relief follows suffering. Yet pain itself, pain as pain, is rarely the concep-
tual core of life writing. For one thing, as Morris argues, no one really wants to
know about pain, and certainly not the kind that endures without explanation
or lasting assuagement. For another, pain, though perhaps understandable as
a specific and treatable bodily condition, is also largely unverifiable. “To have
pain is to have certainty,” as Scarry writes; “to hear about pain is to have doubt”
(13). One difficulty facing the writer of pain is thus how to achieve the kind of
truth-telling we expect of memoir (particularly in an era somewhat primed by
a few outrageous exceptions to be suspicious of the genre, even as we clamor
for more of it). Moreover, part of the misery of pain—the pain of pain, as it
were—is precisely its unpredictability, its seemingly arbitrary course, its chal-
lenge to our methods of saying and knowing who we are. Is there, given these
complexities, the autobiographical form of pain?
Much recent work in Pain Studies focuses on the utility of narrative to both
expressions and alleviations of pain. In a 2001 article published in JAMA, for
example, Rita Charon writes that “medicine has begun to affirm the importance
of telling and listening to the stories of illness” (1899) as a way of mitigating
suffering. Appealing to physicians to refine what she calls “narrative compe-
tence” (1897) and “diagnostic listening” (1899), which she cites as key elements
in the practice of “engaged,” “empathic and effective” healthcare, Charon insists
that physicians must “learn how to embue the facts and objects of health and
illness with their consequences and meanings for individual patients” (1898).
Such emphasis on the significance to medicine generally of the conversations of
the doctor’s office seems obviously connected to the growing popularity of dis-
ability and illness life writing. As more people put to paper their experiences of
painful corrective or rehabilitative procedures and often egregious insensitivity
on the part of practitioners, so have some in the medical community responded
with an acknowledgment that narrative matters—providing, as the editors of
Narrative Based Medicine have put it, “meaning, context, and perspective for
the patient’s predicament” (6).1
1.  Curiously, in Bayliss’s “Pain Narratives,” the injunction to pay careful attention to the “narrative
[that] comes pouring out” of a patient in pain—because “the exact words and the sequence in which
 Life Writing and Lyrical Pain 245

The idea that any experience of pain, specifically, is as much a function of

psychology and environment as of physiology seemed nearly a given even 30
years ago. In his 1973 book The Puzzle of Pain (and again in his revised edition
of 1983, The Challenge of Pain), Ronald Melzack declares that “pain perception
[. . .] cannot be defined simply in terms of particular kinds of stimuli. Rather,
it is a highly personal experience, depending on cultural learning, the mean-
ing of the situation, and other factors that are unique to each individual” (22).2
This suggests an understanding that, as a perceptual experience, pain needs to
be examined within the context of a person’s whole familial, social, psycho-
logical, emotional, corporeal history: in other words, that any moment of pain
amounts to an autobiography of pain. Narrative as such, however, may have
its limitations as a form for communicating pain, a bodily event with no clear
or inevitable etiology, definition, or description. Unlike more predictable, even
unchanging conditions (many of which do not entail pain at all), chronic pain
pursues its own mutable course, ever-present and yet elusive. How, then, do we
capture it in something like legible written form?
Using “The Pain Scale,” a work of creative nonfiction by Eula Biss, as my
touchstone, I would like to consider the lyric essay as pain’s most suitable auto-
biographical genre. Almost as hard to define as pain itself, lyrical essay has
emerged as a cousin of personal essay that is by turns elusive, imagistic, ecstatic,
discontinuous, and melodic, more often circling, symbolizing, and echoing life
events than writing them out in causal, chronological ways. Lyric essays pro-
they are used often provide an invaluable clue to the diagnosis” (75)—seems to transform midway
through the essay into a simple taxonomy for practitioners of what types of conditions are usually
indicated by certain descriptors, as well as a warning about the tendency of patients’ narratives to be
unspecific rather than clarifying (“Beware of the roving hand!”; 79). The importance of a patient’s nar-
rative about pain thus seems primarily concerned with confirming the physician’s diagnostic skills,
rather than establishing new modes of experiencing pain or communicating its sensations to others.
Kleinman offers a more satisfying and comprehensive study of how practitioners might integrate
some plan of treatment with their patients’ whole story—not only of the onset of pain or symptom
but of background, personal life, psychological state, and so on. Kleinman devotes several chapters
specifically to chronic pain.
2.  These sentences appear on page 28 of The Challenge of Pain, co-authored with Patrick D. Wall.
Interestingly, in a more recent study called Why We Hurt: The Natural History of Pain, neurosurgeon
Vertosick links pain with sex in a reductive analogy where these are “simply the physiological sub-
strates for deeper metaphysical phenomena” (i.e., suffering and romance), which require “a human
dimension in addition to the raw biology—a dimension of intellect, imagination, emotions, cultural
influences, and spiritual beliefs” (8). This separation of pain and suffering (much like that between sex
and gender) seems too strenuously to excise the personal, psychological, and cultural from the experi-
ence of pain; in other words, is there pain outside of a culturally or emotionally informed perception
of it? Much later in the book, Vertosick refers to the necessary “discipline” of pain, without which
we might “neglect our bodies until they become battered beyond recognition” (188). Such language
reveals the bias of the book, encapsulated in the chapters’ titles (“The Human Affliction,” “A Woman’s
War,” “The Horror,” and so on): that a body in pain is in part a necessary evil helping us to avoid even
worse corporeal afflictions.
246 Susannah B. Mintz

ceed as much by associative juxtaposition and fragmentation as by the logic

of proof or argumentation, ruminating or meditating rather than expounding.
Meaning, in this hybrid form, derives as much from an accumulation of parts,
and from an intensity of sound and feeling, as from narrative control or pur-
pose; to the contrary, as Brenda Miller and Suzanne Paolo have explained, lyric
essays require that we “surrender” (148)—to the operations of intuition, say, or
to the pleasures of the quest—because the structure of a lyric essay “emphasizes
what is unknown rather than the already articulated known” (147). The lyric
essay gestures, seeking (and here I invoke Sven Birkerts’s description of certain
memoirists as “lyrical seekers”) but not necessarily concluding the meaningful-
ness of relationships and patterns in memory and experience.
In “The Pain Scale,” a lyric essay from 2005, Biss does not render pain as
an adjunct to other experiences, like addiction or disease, as many memoirists
do; instead, pain is her source, her vocabulary, her point. There is no writing
the end of pain, because pain does not end; there is no conclusive explanation
for her pain, and thus no coherent narrative in the essay. Biss capitalizes on
the distinctive associativeness of lyrical essay to capture the movement of pain.
Gaps in the prose remind us of the inarticulable sensations of pain, the silence
it commands, but Biss’s short paragraph structure also suggests, unexpectedly,
the opposite—that without pain there is no language. “Is no pain desirable?” she
wonders (28), and though the essay attempts to concretize in words an unim-
aginable and inescapable pain, it also, of course, brings the body-in-pain to the
fore in a way that makes pain, if not exactly pleasureable, in some way constitu-
tive. It is not simply that having pain individualizes Biss in her suffering, but
that she becomes further identified in her method and manner of expressing
that pain. This is the point Arne Johan Vetlesen makes in his chapter on chronic
pain in A Philosophy of Pain: “how I deal with my pain [. . .] says in a special
way something profound and essential about who I am, i.e., a pain-transmitted
exposure and clarification of my individuality, my differing nature” (31).
It is also the point Petra Kuppers has made of pain performance art, that pain
does not inevitably obliterate a sense of self but reconnects body and mind,
restoring “our fleshly character” to the experience of and conversation about
identity (77). Kuppers suggests that in “concretiz[ing] the body, foreground[ing]
it experientially,” pain has the capacity to make us more aware of our “embed-
dedness” (86): in relationships with others, in social structures, in forms of
work and productiveness. In this sense, pain becomes affirming rather than
negating, an avowal of the self ’s aliveness and even kinesthetic impact on the
world beyond its boundaries. And while she acknowledges that personal nar-
rative can mask the experience of pain because of the inexact correspondence
 Life Writing and Lyrical Pain 247

of pain to language, Kuppers nonetheless invokes reading as a powerful mech-

anism of understanding what someone else’s pain feels like. When an ethically
sensitive “reading apparatus kicks in,” she writes, normative reactions to the
supposed horror of pain may get usefully challenged, opening a space for new
articulations of how we conceive of and therefore live with pain (88–89).
This may be lyric essay’s unique capacity on the page, to represent the self-
in-pain by giving pain a rich experiential dimensionality that it lacks in more
conventional accounts.3 Morris points out that modern societies tend falsely to
demarcate pain as having either a mental or physical etiology (what he calls the
“Myth of Two Pains”; 9), then further reduce the latter as a purely biochemical
process of “nerves and neurotransmitters” (2) to which we respond confidently
if also frantically with drugs (“our immense faith,” as he puts it, “in chemical
assaults on pain”; 61). His appeal in The Culture of Pain is for an end to that rigid
dualism as well as for a way of thinking about pain that acknowledges the fact
that pain is thought—interpreted and given meaning by a particular mind in
a particular historical moment—as much as it is felt. A lyric essay, I argue, can
perform the kind of conceptual shift for which Morris calls, situating pain along
the pathways not just of nerves but of subjectivity, of relationships between self
and other, imagination and words. The essay, as Annie Dillard once said, can
do “everything but fake it”: “there’s nothing you cannot do with it; no subject
matter is forbidden, no structure is proscribed” (xvii, xxii). Such is the nature of
pain—demanding, in its formidable presence, that it be communicated, though
the forms of that rendering are as various as the varieties of pain itself.
Eula Biss’s “The Pain Scale” is organized according to its title, beginning
with zero, “No Pain” (28), and ending with ten, “The Worst Pain Imaginable”
(41). Other scales serve as additional frameworks within the 11 sections: the
Beaufort scale, which measures wind; the Wong-Baker Faces scale, designed to
assess children’s physical pain; Robert Forslund’s Alternative Positional Num-
ber System, which substitutes the letter A for the number 10; and the relative
degrees of the Fahrenheit, Celsius, and Kelvin temperature scales. Occasional
references to Dante’s Inferno and to popular notions of hell, along with litanies
of pain-inducing experiences (a razor cut, loss of a limb, starving, and more),
offer imaginative counterpoint to the more strictly numerical schemas. Biss’s

3.  I would like to be able to include Cameron’s trenchant and evocative Beautiful Work: A Meditation
on Pain in this discussion because it is, if nothing else, intensely lyrical in its inquiry into the mean-
ings and stories of pain. It is not, however, strictly life writing. Though perhaps largely autobiographi-
cal, the book deploys a fictional character named Anna to narrate its story, and the publisher’s own
description highlights the text’s eschewal of memoir proper as overly constrained in scope. At the risk
of perpetuating a kind of generic territoriality, my interest in this essay is in forms of lyrical expression
that give voice to pain without sacrificing authorial presence.
248 Susannah B. Mintz

own account of mysterious, unrelenting physical pain, told in abbreviated snip-

pets, weaves between these two poles in a way that suggests their limitations as
much as their efficacy. Any single scale is made to seem absurdly insufficient
as an indication of the severity or sensation of pain (or, indeed, of anything);
but the totality of assorted descriptors provides no more accurate or reliable a
method of assessing the author’s condition. At the end of the essay, the worst
pain imaginable either cannot be felt (“I am incapable of imagining the worst
pain imaginable,” Biss writes; 31), or, in its “devastation” (42) of the thinking,
feeling subject, returns both language and feeling to the beginning again, “back
to zero” (42).
A pain scale, as this essay makes clear, is both a fiction and a fixative. Asked to
rate pain according to numbers meaningful only in relation to each other or to
abstracted qualifiers, patients must create a story that bears no real or absolute
relation to physical sensation, still less to the total experience of being in pain; a
rating of 6 hurts “more” than 5 but less than 7, which is less than the “worst” pain
one has ever felt or could imagine, but more than a “little,” and one person’s 6 is
necessarily different from another’s. Biss tells us that “determining the intensity
of [her] own pain is a blind calculation” (33), any number simply a comparative
value based either on previous experiences of pain (always already indefinite in
their own particulars) or on what she calls “theoretical experience[s],” like “the
pain of burning alive” (33).
Given that one’s responses to a pain scale can be used to justify continuation
of services, such as physical therapy, for insurance purposes, some degree of
creative computation would seem inevitable. At the same time, of course, it
is precisely the imprecision of the language of pain that grants those arbitrary
numbers the power of validation, fixing the patient along the scale of value so
that pain can become intelligible to others. When there is “nothing to illustrate”
pain, “no evidence of pain on [the] body,” numbers become “proof,” Biss says
(35), according the person in pain a certain status and in turn what may be
deemed an appropriate level of care. This method of assessment participates
in what Morris refers to as an ill-advised “quest for absolute clarity” (16) in the
defining of pain. If pain itself, despite the ubiquity of the word and its apparent-
ly recognizable meaning, is far from consistent, then our vocabularies of pain
should seek to match rather than obscure that indeterminacy. To give meaning
to the self-in-pain is not so much to quantify its discomfort as to pay attention
to the ways in which pain is made meaningful—imagined, understood, experi-
enced—in the first place.
Some form of narration, then—or to be more exact, a communicative utter-
ance—becomes crucial. But given the predominance of numerical measure-
 Life Writing and Lyrical Pain 249

ment in the medical response to pain (as Biss recounts, “every time I go to the
doctor and every time I visit the physical therapist, I am asked to rate my pain
on a scale from zero to ten”; 30), how does a literary-minded sufferer demedi-
calize pain in order to communicate something of a state that borders on word-
lessness? To put this a different way, we might ask how the person in pain can
manage to do a kind of mental pain-work, to “make” something imaginative
of an experience that nearly by definition obstructs the process of imagining—
a process that, because it is not a “felt-occurrenc[e]” (in Scarry’s terms; 162),
would in turn seem to preclude realization of physical sensation. How to offer
readers an imaginative rendering of feeling, when feelings cannot be imagined,
even by the person who has pain?
Biss responds to this conundrum in her leaps of statement, description, and
narration. It seems at first that there is some correlation between the content
of each section of the essay and the advancing numbers of the pain scale. Two
(represented as ← 2 →) inspires reflection on various dyads, such as mind and
body or the adulterous lovers of Dante’s second ring of hell, as well as explan-
ation of the Beaufort scale’s force 2 wind. ← 3 → is the value Biss assigns her
pain on her first attempt to quantify it. We cannot know how this feels, only
that “Mail remains unopened. Thoughts are rarely followed to their conclu-
sions. Sitting still becomes unbearable after one hour. Nausea sets in. Grasping
at the pain does not bring relief. Quiet desperation descends” (33). At ← 7 →,
Biss “would happily cut off a finger [. . .] if [she] could trade the pain of that
cut for the endless pain” of now (37). As a prime number, 7 prompts a discus-
sion of infinity, of square roots and approximation. “No measurement is ever
exact,” Biss writes, wryly implying her pain; the infinite repetition of decimals,
the inexactitude of mathematical calculation, gives the lie to the precision of a
numerical system designed to capture the experience of pain.
The sense of correspondence between number and narrative is thus an illu-
sion, as much of a fiction as the relationship between number and sensation. The
form of the essay both invites and denies our belief that something is progress-
ing, that the author’s pain steadily increases to some point at which we hope
she will be assuaged or healed. To the contrary, at 0 →, the speaker is “ic[ing]
her pain” and waking up to its “warm throb [. . .] returning” (29), whereas at
← 10, she jokes with her physician father that she would trade neither a limb
nor sight for abatement of her pain, confusing her own statement that she is
“always [in] the worst pain imaginable” (41, my italics). In fact, mention of actu-
ally being in her “worst pain” comes at ← 9 →, where she writes in one short
paragraph, “I can remember thinking, ‘This is not beautiful.’ I can remember
being disgusted by the very idea,” but in the next, “The longer the pain lasted,
250 Susannah B. Mintz

the more beautiful and impossible and absolutely holy” the vicissitudes of pain,
the way we talk to ourselves in pain, become (40). The sensation of pain, in
these contradictions and inconsistencies, is hardly given precise dimension, but
an experience of pain does take shape. The many facets of the essay, its clipped
pace, abrupt changes of subject, odd juxtapositions—these depict both a mind
hard at work figuring out the self in pain, and a person actually in pain, alter-
nately describing the sense impressions of pain, intellectualizing pain, and shut-
ting down altogether as pain takes over.
What emerges is the kind of acute awareness of, even “astonishment” about, a
state of being that Birkerts has cited as the characteristic feature of lyrical essay
(27). The “specific circumstances” of that state, in his words, are less important
than the autobiographer’s act of pursuing the self, seeking to comprehend its
“persistence” (41). To the degree that Biss’s pain coincides with selfhood (and
vice-versa), “the longer the pain persisted” becomes paradoxically synonym-
ous with the ongoing-ness of her self (39). She declares in the section following
← 8 →, “I no longer know who I am” (38), but of course the narrating self carries
on beyond and despite that dissociation, no less present—if also no more cohe-
sive—than before. Self-knowledge here is equivalent to making some kind of
sense of pain, but because her pain ultimately makes no sense (it has “no defini-
tive cause” and “no effective treatment”; 39), the attempt to write pain-as-pain
produces an essay that also resists transitional logic and containment. There
is in lyrical essay, as in pain, an immediacy, a simultaneity, of thought, feeling,
and memory that both mimics the operations of consciousness and defies the
impulse to make order out of psychological and/or physical chaos. Some dis-
ability scholars have protested that the compulsion to make meaning out of
illness and disability is “pernicious” in that it embeds, obscuring from critique,
a fear of disablement as tragic and diminishing (if we must live in such intol-
erable conditions, we must at least “learn” something from our experience).4
This is why, I think, the structure of lyric essay so suits the articulation of pain,
because, to invoke Birkerts again, what matters is less the wrenching of life’s
details into coherent, linear narratives than a willingness to immerse oneself
imaginatively in, to be “amaze[d]” (41) by, one’s own existence.
A signature “problem of pain,” as Biss explores it, is the fact that no pain can
be exactly shared by two people, and yet pain is always felt in a social environ-
ment in which individual thresholds of pain have an impact on how we respond

4.  Charon, for example, writes that “the narrating of the patient’s story is a therapeutically central act,
because to find the words to contain the disorder and its attendant worries gives shape to and control
over the chaos of illness” (1898). For the counter position, see Ingram and Overboe. “Pernicious” is
Ingram’s word (244).
 Life Writing and Lyrical Pain 251

to others’ suffering. Many have cited this peculiarity of pain, that it is both a
universal and utterly solitary experience, that in it we are inherently alone, even
as how we understand it is invariably shaped by our cultural milieu: by family,
science, spiritual practice, and so on.5 This complex network emerges in “The
Pain Scale” as a kind of conversation that Biss stages between parents, doctors,
friends, poets, theologians, mathematicians, astronomers—the many sources of
belief about the how and why of human experience. This is what Charon refers
to as “multiple sources of local—and possibly contradicting—authority [that]
replace master authorities; instead of being monolithic and hierarchically given,
meaning is apprehended collaboratively, by the reader and the writer, [. . .] the
physician and the patient” (1898). Again, it is through the lyrical structure of her
essay that Biss effects a disruption of the “overarching metanarrative[s]” (Mor-
ris 283) that presume to say what pain is. Just as no one scale could ever accu-
rately convey the feeling of pain, so too can no single explanatory system suffice
to understand the meaning of pain. This sets in motion a dialectic of efforts to
conceptualize pain in a range of forms and circumstances.
So Galileo’s “extensive lectures on the mapping of Hell” (Biss 36) give way to
a psychologist’s “rational” advice on how to endure chronic pain (37). Expert
opinion on “why some pain resolves and other pain becomes chronic” (38)
introduces “the medical definition of pain,” “another theory of chronic pain,”
and her mother’s claim to have “a very high pain threshold” (39). “The gaping
wound in Christ’s side, [. . .] the blood, the nails, the cross to bear” (40) juxta-
pose the neutralization of pain as a numerical value, the purely physiological
“medical definition of pain” as tissue damage (39).6 And so on. In the accumula-
tion of such contrasts—such incompatibilities, even—Biss performs in writing
the contradictions of pain that Kuppers enumerates in her discussion of live
pain performance: the simultaneous “opacity at the heart of pain” alongside
its “communicative power,” the fact that “pain is expressive” (human bodies
in pain being the subject of a great deal of visual art) but at the same time
“incommunicab[le],” impossible to be related or described (74–75).
To put this in slightly different terms, the kind of pain portrayed in Biss’s
essay constitutes what Morris calls “postmodern pain,” a pain that “calls into

5.  Pain may be “a kind of universal state,” writes Vetlesen, but “my pain is my loneliness; it strength-
ens and clarifies the feeling I have of being alone in the world, alone with and in my body, which sep-
arates me physically from everything else in the world. The mineness of the body is identical with the
mineness of the pain: both are now in a radical—or unknown or unsensed—sense ‘mine only,’ not
other people’s” (14).
6.  The International Association for the Study of Pain reported in 1979 that pain is “an unpleasant
sensory and emotional experience associated with actual or potential tissue damage, or described in
terms of such damage” (250).
252 Susannah B. Mintz

being multiple systems or subsystems of explanation, each with its own dis-
tinctive language or discourse, none of which holds absolute priority” (283). In
this context, “The Pain Scale” both is and is not wholly “about” pain. Pain is the
essay’s essential subject, its obsession, its reason for being. But the essay is also
a demonstration of “the limits of understanding,” in Morris’s words (285), an
iteration of the fact that pain “is difficult to capture” (Biss 32). In effect, pain and
discourse become inseparable in “The Pain Scale,” intertwined in a dialectic of
event and reaction, of body and mind, of which selfhood is the legatee.
In the introduction to her book Rejected Bodies, philosopher Susan Wendell
describes the onset of myalgic encephalomyelitis (or chronic fatigue syndrome,
as it is known in the U. S.), a condition with which she had lived, at the time of
writing the book, for at least a decade. First on her list of continuing symptoms
of the disease is “constant muscle pain,” along with weakness, fatigue, dizziness,
depression, loss of memory, nausea, and headaches (3). Such a litany of painful
symptoms would seem to preclude the possibility of enjoying life, but Wendell
insists otherwise, that “someone can be disabled or ill and also [. . .] be happy” (4).
A significant feature of Wendell’s adjustment to the ongoing effects of her ill-
ness is a reframing of the meaning of illness and its attendant pains. Again in the
introduction, she writes that her “struggles now are not primarily with the dis-
ease” but instead “primarily social and psycho-ethical” (3). In keeping with the
thrust of contemporary disability activism, Wendell locates the disabling force
not in her own body but in a culture that privileges productivity, independence,
and bodily control, and that in turn conceives of disability as a diminishment
of social value. Like Morris, Wendell also urges the demystifying of medicine as
the sole cognitive authority according to which we understand pain. If we are to
“communicate the phenomenology of bodily suffering,” in her words, we must
widen our conceptual field, turning away from a “vocabulary” of “biomedi-
cine” that can “exclude or distort those aspects of patients’ experience that are
most important to them” (136).7 In the manner of many memoirists of disability,
Wendell makes a strong bid for revising the language we use to talk about the
body as both cause and effect of altering how we experience and cope with it.
Since chronic pain by definition flouts the premise of Western medicine that
suffering can and should be cured, a person’s capacity to “live well” (4) in pain
may be unnecessarily strained by the absence of models of how to do so.
Pain is understood to be the body’s messenger, a sign that something is hap-
pening that requires attention (Biss writes that pain has even, by some, been

7.  This is a point Charon has also made: physicians, she suggests, have “learned that acts of reflective
narrating illuminate aspects of the patient’s story [. . .] that are unavailable without the telling” (1899).
 Life Writing and Lyrical Pain 253

considered a “fifth vital sign,” an indication of relative health; 33). The signals
of chronic pain, however, are mixed—something is happening, but one does
not necessarily have to take action in response to it. This is what Wendell calls
the “crisis of meaning” of chronic pain: bodily sensations must be reinterpreted
so that the individual does not feel “overwhelmed or victimized” (173) by a
sensation that may be at once unpleasurable and untreatable. Of her own situ-
ation, Wendell writes that she “must remind [her]self over and over again that
the pain is meaningless, that there is nothing to fear or resist, that resistance
only creates tension, which makes it worse” (173). From an urgent warning that
might impel us toward medical intervention, on the one hand, or a search for
emotional, psychological cause, on the other, pain becomes simply a condition
in the moment, a feeling to be incorporated (I mean this somewhat literally)
into one’s sense of self, rather than feared or eradicated as a kind of mortal
enemy.
The absence of meaning that Wendell invokes here, I think, is to be under-
stood as the uncoupling of pain from the kinds of myths and messages with
which we are accustomed to respond to it. To say that “the pain is meaningless”
is to relieve the sense of obligatory action or the idea that pain weakens us in a
more social sense, reducing us to the level of our corporeal mortality. Since our
cultural tendency is to react with surprise and even suspicion to someone who
“does” nothing about her pain, “meaningless” pain that is frankly acknowledged
and felt challenges the powerful discursive equation between doing and taking
control. And to the extent that “being in pain” is nearly a species of contradic-
tion—if legitimate “being” in a Western sociomedical environment means to
have mastery over the pains that are a sign of frailty or, more treacherously, of
the body’s independence from the mind—then Wendell’s accommodation to
her pain might almost be understood as a political act.
But Wendell also claims that her “experience of illness has been profoundly
meaningful,” leading her to “a changed identity.” How then is pain meaningful
and meaningless at once? Does a search for meaning collude in the repressive
notion that disability generally can only be tolerated if it produces significant
life lessons or characterological improvement? The tension that arises in Wen-
dell’s references to the meaning of pain has to do with an ambiguity in her dis-
cussion of identification. Pain is meaningful in that it forces a restructuring of
her priorities and initiates the “philosophical reflections” on embodiment that
are the focus of her book; to “identify” with pain in this context is to accept hav-
ing “a new body” and “a new social role” (177). Yet pain is also meaningless in
that, like many others, Wendell rejects a derogatory identification of disability
with devaluation or misfortune; pain does not mean that she is psychologically
254 Susannah B. Mintz

or spiritually damaged. Of course, as her own phenomenologically inclined dis-

cussion makes clear, identity is embodied; it is the types of meanings we ascribe
to the body that must undergo transformation, rather than the fact of meaning
itself. This is how we square a certain resistance to the imposition of meaning
with a position such as Morris’s, for more meaning, and how certain forms of
life writing such as lyric essay can provide a useful counterpoint.
The question raised in these various sources is in effect whether or not pain
has to mean something in order to be withstood. Morris worries that “the new
world of chronic pain, which finds its most prominent symbol in the prolif-
erating offices of freshly opened pain centers and clinics, is a world in which
pain has become almost utterly without meaning” (56). In our haste to rid our-
selves of discomfort, we ignore the social dimensions of pain—its historicity,
its implications, its relationship to subjectivity. For Morris, then, making pain
meaningful entails restoring the fact of it to our total sense of ourselves as well
as amplifying our understanding of pain by reading it through a range of lenses.
To put this back in Wendell’s terms, we must learn “how to live with the suf-
fering body, with that which cannot be noticed without pain, and that which
cannot be celebrated without ambivalence” (179).
What is philosophical and exhortatory for Morris and Wendell becomes lyri-
cal for Eula Biss, as if “The Pain Scale” had taken up the battle cry in expressive
and autobiographical rather than scholarly form. The persona of Biss’s essay is
in pain—there is no point at which the level of the pain she records experien-
cing is “No Pain,” even at zero. But though she does “cry over the idea of it last-
ing forever” (37), at no point in the essay does she recount actually trying not
to “be” in pain. To the contrary, pain becomes one of her vital signs: “I breathe,
I have a heartbeat, I have pain” (40). The verb seems critical: her own language
takes possession of pain as an element of ongoing-ness; to have pain is to be
alive. One important feature of an essay like “The Pain Scale” is its demonstra-
tion of a person carrying on with pain, even if pain dominates this particular
“moment”—or the series of fragmented moments that a lyric essay will neces-
sarily gather. Perhaps more radically, the essay sustains pain, as if its purpose
is not at all to assuage but rather to perpetuate it. Vetlesen remarks that “the
accepted and often repeated assertion that pain is something humans hate and
seek to avoid is only half the truth” (98). The other half, according to him, “has
to do with how we seek it, intensify it, create it and are fascinated by it.” This
too seems a significant aspect of the lyricism of “The Pain Scale,” its vacillation
between—but also balancing of—these extremes.
And though Biss’s autobiographical “I” laments that she is “alone with [her]
pain” (33), she also presents herself as a person in a social network; in addition
 Life Writing and Lyrical Pain 255

to doctors, physical therapist, and psychologist, she mentions her father and
mother (and their relative pain thresholds) and a “friend in Honduras” (33).
Moreover, she is acutely aware of the pain affecting others in the world: the
agony of “a napalmed Vietnamese girl” (33), “an Israeli boy with a bloodstained
cloth wrapped around his forehead” (34), “a prisoner standing delicately bal-
anced with electrodes attached to his body” (34), a “crying baby” (35), the “50
million Americans [who] suffer from chronic pain” (35). These are the gestures
of an essay whose subject speaks from a place of meaningful pain—nuanced,
situated, imagined, alive.
One might protest that “The Pain Scale” fails to make pain truly lyrical in that
it denies us (studiously, it seems) any explicit evocation of what the author’s
pain feels like—even, more generally, of what sort of pain it is. Where is pain
located in her body? Is it a generalized body pain? An ache, a burn, a throb,
a stab? Indeed, pain seems more often intellectualized than felt in the essay,
hidden behind the author’s display of knowledge, reading, research about pain.
“The sensations of my body may be the only subject on which I am qualified
to claim expertise,” she tells us (31). Why, then, does she not actually play the
expert in this important regard, the expert we assume the autobiographer to be?
One obvious answer is pain’s resistance to representation: the essayist does
not give direct utterance to her pain simply because she cannot, by virtue of
the inadequacy of words to convey a feeling of pain. But I think the absence of
direct description in the essay is more tactical than inevitable. In one way, Biss
diverts attention away from the details of what she certainly knows her audi-
ence will be curious about, the essay’s repeatedly invoked transcendental signi-
fied: “my pain [. . .] my pain” (29), “my pain” (30), “the pain I already feel” (31),
“an extraordinary pain” that “floods my body” (31), “my own pain [. . .] my pain
[. . .] my pain” (33), and so on, in a kind of compulsive incantation that would
seem to testify to the mysterious nature of pain.
But in another way, that very repetition of “pain” holds the word, and all
that it conjures, continually before us. Pain (experiences of it) and “pain” (the
ultimately empty signifier) are ubiquitous, no matter how little we know of each
other’s pain, no matter how insufficient or inaccurate any attempt to quantify
sensation. Language is finally as arbitrary as the numbers on a pain scale—so
the experience of a “stubbed toe” (30) has the same name as being “impaled
with hundreds of nails” (32). Pain itself, pain without evidence or cause, may be
also arbitrary, despite its spectacular capacity to determine our thinking, our
mood, our behavior. Yet there is no essay without pain, no writer without the
essay, no sense of self without the imaginative work that pain ushers into being.
Thence the essay’s lyricism: that the play of intellectualism coincides with an
256 Susannah B. Mintz

acute awareness of suffering, that in the chanting repetitions of “pain” what

might otherwise seem a kind of tongue-in-cheek nod to the meaninglessness of
that term accrues a terrible beauty: “The pain of feeling, the pain of caring, the
pain of doubting, the pain of parting, the pain of paying. [. . .] The pain of learn-
ing, and the pain of reading. // The pain of trying. // The pain of living” (30–31).
Despite its ostensible point—the secure quantification of pain—“The Pain
Scale” invites us to think not so much in terms of identity and definition but
rather of equivalence and transformation. For instance, though she can no
more remember a pain she no longer has than she can remember not having
the pain she is currently in (such is the elusiveness of pain not only to words
but also to sense-memory), Biss writes that she can “ask [her] body to imagine
the pain it feels as something else” (37). So pain might be experienced as heat
or adopted as a “vital sensation” (40). And what of pain that is also experienced
as pleasure, a conflation that would seem, by the official definition of “pain,” to
be impossible?8 Yet Biss tells us that the “pain of treatment” is both “extraordin-
ary” and “deeply pleasurable” (31). Pain somehow is and is not itself; this pain
is and is not that. Against the various theories, lectures, statistics, and tests that
the essay invokes as methods of measurement, then, pain here takes on a far
more imagistic and relational quality, as if there were no pain outside of how we
compare or contextualize it—even if, as the author says, “you cannot compare
my pain to yours. And, for that reason, cannot prove it insignificant” (39). We
return to the paradox of pain, that no one pain (no one’s pain) is like any other
pain, even as pain somehow only exists as the likeness of metaphor, the unlike-
ness of contradiction.
At the same time, Biss writes, “There is a mathematical proof that zero equals
one. Which, of course, it doesn’t” (31).9 Does this mean that pain, finally, is not
heat, is not pleasure, but only, always, uncomfortable, even agonizing sensa-
tion—that is, “pain”? Does it mean that, however much elusion pertains to the
act of quantifying pain in a medical context (“‘How do you feel?’ the doctor
asks, and I cannot answer. [. . .] I begin to lie”; 31), pain cannot be made either
more or less than it is just by assigning it a number or an expression that satis-
fies a particular institutional requirement? We might think of pain as a “task”

8.  To quote again the International Association for the Study of Pain, pain is “always unpleasant [. . .]
Experiences which resemble pain, e.g., pricking, but are not unpleasant, should not be called pain”
(250).
9.  I am reminded of Kriegel’s claim that “pain was not synonymous with mortality. [. . .] Pain might
validate the specific moment in time, but it didn’t have very much to do with the future” (207).
Kriegel’s refusal here to turn pain into something else—specifically, a salutary lesson in his relation-
ship to the immutability of death—means that he experiences pain on its own terms, in the present,
without recourse to moralization or denial.
 Life Writing and Lyrical Pain 257

that we are called upon to perform (Morris 171–72).10 Kuppers offers an alterna-
tive interpretation of pain as “an affirmative mode of experience, creating life
and sensation in the face of dullness” (87). Pain is also an opportunity for what
Ato Quayson calls “empathetic repositioning”: the moment when a “nonsufferer
of pain” becomes “a witness to pain,” recognizing and thus validating “the truth
of pain” experienced by the sufferer (80). But such figurations, sophisticated
cognitive responses to the problem of pain as a societal and interpersonal phe-
nomenon, do not, of course, tell us how pain is felt or how it might be best
articulated. In that fundamental bodily and also emotional way, pain is reso-
lutely “pain.”
The tautology of pain, then, becomes the lyricist’s challenge—how to give
voice to an experience at once indescribable but also originating in “the substan-
tial center of subjectivity.” Those are the words of E. M. Cioran, who declares
that the “lyrical mode is utterly barbarian in its expression” (4–5). To be lyrical,
according to Cioran, “means you cannot stay closed up inside yourself. The
need to externalize is the more intense, the more the lyricism is interiorized,
profound, and concentrated.” Suffering, he goes on, “spring[s] up from the
deepest and most intimate part of our being. [. . .] Almost all illnesses have lyri-
cal virtues” (4). And lyrical writing, he suggests, entails the “objectification” of
inner experience in “fluid, irrational material” (5). If there is something perhaps
too pat in Cioran’s darkly aphoristic style, in what smacks of a stereotypical
and problematic romanticizing of illness, his notion of the irregularity of lyrical
utterance is nonetheless useful to a discussion of a type of personal essay that
can both describe and enact being in pain. For what is pain, too, if not “utterly
barbarian in its expression”?
We tell our experiences of pain, Charon argues, “not only to unburden [our]
selves [. . .] but, more fundamentally, to claim such events as parts, however
unwelcome, of [our] lives” (1901). If part of our challenge is also to experience
the body without persisting in a problematic effort to “make sense” of it—which
is simply a more benign way of saying that we force unruly bodies to conform
to some kind of coherent narrative—then the lyric essay is our perfect auto-
biographical form: profound, emotionally resonant, thoughtful, urgent, discon-
tinuous, whole.

10.  Morris is quoting Viktor E. Frankl, psychiatrist and author of Man’s Search for Meaning (1946; ori-
ginally titled From Death-Camp to Existentialism). Morris explains that Frankl’s experiences at Aus-
chwitz and Dachau led him to a theory of pain and suffering as a kind of task that would call people
to what he called “right action.” The “crisis” of suffering, in Morris’s words, “will ultimately confront
us with the necessity to act” (171).
258 Susannah B. Mintz

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