I began my orthopedic surgery residency in 1981. I had an unusual path into this specialty in that I had completed two years of internal medicine residency in Spokane, WA prior to moving to Hawaii. Most orthopedic residents have had one or two years of general surgical training prior to specialty training. My fellow resident was extremely talented, which made the situation more intimidating. He also was of tremendous help in getting me through that first year.
In retrospect, I was not mentally ready for the switch from medicine to surgery. I could barely tie a knot, much less make an incision. My stress levels went through the roof.
The burning begins
I began to notice a slight burning sensation on the balls of my feet as I went for a jog. I did not think much about it and thought that it was a combination of the warm pavement combined with the jarring associated with running. It became progressively more constant and clearly was not due to the heat of the pavement.
Feet on fire
I moved to Sun Valley in 1999. It was a difficult time for me personally. The warmth in my feet was aggravating but still tolerable. One night that abruptly changed. I had experienced a particularly difficult day and become extremely upset. Within 12 hours the burning dramatically increased to a level where they felt like they were in a toaster oven. It didn’t matter what I did the pain wouldn’t abate. Seeing patients usually distracted me from the pain. Now, it didn’t help. The only time I didn’t experience the severe pain was during surgery and it persisted for six months.
It strikes me as I am writing this how frustrating it is to describe your pain to other people. Words really cannot convey the severity of this pain and the absolute frustration I felt being trapped by it. I can sense this same frustration in almost every patient who is trying to convey his or her suffering to me. Hand over the stove
I knew how angry I was at life. I intellectually knew that my anger was a problem but I didn’t connect it to the pain nor could I let it go. Every possible diagnostic was normal. I continued to sink into what I now term the “Abyss.” I define the abyss as anxiety multiplied by anger multiplied by time. I could not see a solution or the possibility of one. I completely lost hope.
Understanding my victimhood
It was on Mother’s Day 2002 that I realized what a victim role I had placed myself into. Prior to that moment I honestly didn’t understand what being a victim entailed. I was always frustrated and was quick to blame anyone close by for my problems. As I felt so “right” in having these emotions, I thought it was just a normal way to be. It is such a powerful role that I realized that I would never willingly want to surrender it. I had to simply choose whether I was going to remain in that role or not. I chose to give it up.
Within two weeks the burning began to abate and within three months it returned the baseline nuisance pain I had experienced for over 20 years. I’ve experienced intermittent flare-ups in the last couple of years that clearly were related to extreme stress and lack of restful sleep. I also had quit using the tools that had pulled me out of pain. These episodes resolved quickly once I re-engaged with some basic strategies and realizing how deeply I had fallen back into the victim role.
Pain and anger
The link between anger and pain pathways is absolute. I don’t know anyone who is happy about receiving a painful impulse to his or her brain. This linkage is also the reason it is essentially impossible to have pain relief unless you can truly process and let go of your anger. It has to be your deepest anger. As there are abundant opportunities to experience frustration and anger, this is the most challenging part of this whole healing process.
Burning sensations in your body are one of the symptoms of the Neurophysiological Disorder (NPD).
I am still and always will be a work in progress. Life keeps coming at me and I fall into the victim role multiple times daily. I don’t stay in it as long. I have some writing I need to do today. Ask my wife…