A monk once asked his teacher, “I am alone and in pain, teacher. Please, give me some aid.”

The teacher said, “Venerable student!”

“Yes teacher!”

You have already taken your two Vicodin, and still you say you are in pain!”

~ Gateless Barrier, Case 10

Last week we looked at this koan from a position of emotional anguish, and this week I thought we might explore it from angle of physical anguish. For me, the hook was entering the hospital last week for an out-patient double hernia repair (too much chopping wood and carrying water on my part, no doubt!), getting bathed in a 100mg of Fentanyl during the procedure, and receiving an orange bottle of Vicodin to clutch in my right paw as I left for home. Feeling physically vulnerable and challenged ~my legs remained partially paralyzed until he next morning~ I thought there must be some lower-impact way to manage pain, so I googled various meditation-based programs that advertise themselves as “pain management” techniques.

Pain management is a huge medical market: in the U.S. alone, it is estimated to be a $36 billion business treating over 100 million patients who suffer from chronic pain. Plenty of the affected are trying to find an alternative to opioids: a couple of the guided YouTube videos I spent most of a day following recently had up to 1.2 million views. The methods these videos generally followed are familiar with Zen sitters: follow the breath, attend to the present moment and condition, let go of expectations. The Asian mood music got a bit painful to listen to, and there were some bromide instructions: “Breathe in relaxation, exhale tension… Our natural reaction is resistance to pain, which can cause us to tense our muscles, and ultimately create more pain,” but even these had some value. Research does support the finding that meditation-based pain-reduction methods can be helpful. John Kabat-Zinn, the don of meditation-based stress reduction (MBSR), has consistently found that McGill pain surveys of those attending his two-week seminar show that nearly three-quarters of participants report a 33% reduction in pain; 61% experience a 50% reduction.

Please, give me some aid, asks the monk above. Though my pain was severe for only a short time, the downside of the one opioid tablet I took was a loss of any sense of vital force or breath (氣 Ch qi, Jp ki) in my body. It was pain management through suppression, rather than through cessation, and I felt it hard at first to direct my breath or attention to any part of my body. In the end, what I really preferred was the clarity of the pain to the dopiness of the medication. I also found that suggestions and advise can be cheap: Kabat-Zin, in one of his videos, says “Thoughts of the pain are not the pain itself.” Fair enough. But sometimes, it just really hurts. As a friend once advised another, who said she could no longer stand the unremitting pain of her chronic illness: “Then don’t standing it!” Don’t stand it this moment. And this. And this.