Put out the fire across the river.
~ A Pacific Zen Miscellaneous Koan

In the past year, perhaps because of the pandemic and our social isolation, I have been keenly aware of sickness and pain in the lives I touch. Pain, for me, is something like a fire: a couple of years ago, when I was in sesshin I contracted a severe fever. For several days I lay awake in bed, churning and burning, in a manner which I sometimes work on Zen koans. The pain was my koan, which is to say, it was not a riddle, but was my whole existence.

And then, as a teacher talking  with koan friends, I have heard a lot of stories of chronic pain. Inspiring stories. My only wish is to share those stories with you. So I asked a group of Zen friends who have direct experience with sickness and chronic pain in their lives if we could investigate pain and practice together.

I remember a story a Zen teacher told some years ago. As a young girl, she was exposed to a near-lethal dose of insecticide while on a walk in a farm field with her dog. She was hospitalized; her dog died. The exposure affected her years later with bouts of weariness and nausea. In one episode, she felt overcome, and shouted to her partner, who was also a teacher: “I can’t bear it any longer!” He shouted back, “Then don’t bear it!” For her, that was a turning point in the way she approached her illness.

Mr. F is a registered nurse, who about a decade ago, developed severe rheumatoid arthritis in his spine, which is rare condition. His doctors prescribed high doses of morphine (up to 200 mgs a day), cannabidiol (CBD), steroids, and other medicines, to relieve the pain. None of them seemed to help: he was still in constant pain and sleeping only a few hours a night. So he decided, in conjunction with his meditation practice, to work his way off all drugs. It took three years of constant flashbacks and withdrawal symptoms. He now sleeps six to seven hours a night and takes Tylenol for his pain. “I decided to face the reality, and tried to turn toward it, after doing everything in trying to alleviate it,” he says. “Trying to flee and get away from it just caused more pain; so I began to dance with it.”

Mr. A is a Vipassana meditation teacher. Ten years ago, he was diagnosed with Meniere’s Disease, which is a chronic illness affecting the inner ear and creates severe vertigo, ringing in the ears, and migraine headaches. “I have practiced a lot with pain; a lot of pain, over the years,” he says. When he feels an episode coming, he invites “Mr. Meniere” in for a visit. “Pain often is the thoughts we have about it. The resistance we have. The wanting it go away.” As a mindfulness meditative practice, he notices the location, the intensity, heat, sometimes a fast tapping. “The more you go in, the more diffuse, less solid, less real it becomes. In the end, it all seems to be lacking in substance. It is almost a gateway to emptiness, non-substance.” He admits there are times when the pain was so intense that he cannot even meditate. “I just have to surrender and sit. To bear witness.” He adds, “But all of those words imply doing something. It isn’t even that. This is just what’s happening.”

Ms. P is a clinical psychologist who deals often with patients suffering severe emotional and physical pain, including end of life treatment. “I suggest to people that they focus on their experience of pain, rather than their concept of it.” She asks questions which help the patient focus on the pain: Is it sharp or dull, continuous or intermittent, hot or cold? “When we do that, our physical response changes: the concept of pain is negative, while the experience is considered unpleasant.” She often gives her patients Zen koans as tools for therapy in her practice. Not long ago, she gave a woman who has inoperable colon cancer the koan: “Go straight on a road with 99 curves.” The patient, who only has months to live, stood up and began to laugh and dance in response. Ms. P herself, has suffered chronic rectal fissures, and extreme “pain in the butt,” as she says. An interesting note on the mind and pain: Regularly, when patients came into her office, the pain went away. When they left, it returned.

Often the physical pain can devolve into psychological pain. Mr. S. is a retired therapist, and has for decades enjoyed good health, actively participating in Aikido and Qigong. A few months ago, he got an extremely sharp and piercing pain in his chest, like an arrow had been shot through his rib cage. It was almost unbearable. The medical doctor suspected a connection between his rib cage and thoracic vertebrae might be pinching a nerve. “Dealing with the severe pain brought up an emotional pain and revealed for me old and hurtful behavior patterns.” Prevented from pursuing his normal physical routine, his condition began to attack his “constructed identity,” and generated an abiding self-pity. That, in turn, brought out for him the family monster he grew up with: confusion and aggression in his household. Going out to a small, post-Covid dinner with friends, without realizing it, he made a deeply cutting remark to his wife. By chance, he has been working with the koan, “Does the Loch Ness Monster really exist?” “Up came the monster,” he says, “And the koan taught me the monster could became a teacher in self-compassion.”

Questions:
What is pain?
Should we lean into it or not?
How can we use our meditation practice to holistically help manage pain?
What is the connection between pain and the small mind?

After Great Pain, a Formal Feeling Comes
BY EMILY DICKINSON
After great pain, a formal feeling comes –
The Nerves sit ceremonious, like Tombs –
The stiff Heart questions ‘was it He, that bore,’
And ‘Yesterday, or Centuries before’?
The Feet, mechanical, go round –
A Wooden way
Of Ground, or Air, or Ought –
Regardless grown,
A Quartz contentment, like a stone –
This is the Hour of Lead –
Remembered, if outlived,
As Freezing persons, recollect the Snow –
First – Chill – then Stupor – then the letting go –