Welcome to the fifth season of Invisibilia. I'm Hanna Rosin.
And I'm Alix Spiegel.
Invisibilia is a show about all the invisible forces that shape human behavior, our thoughts, our emotions,
our expectations. And today we have a story about the complicated relationship between pain and attention.
My filthy yellow Honda cruised down the 405 — too slowly, of course, because I drive like my grandmother — to the comforting sound of Alix Spiegel’s low vocal fry.
The sun was setting, a huge red orb sinking down behind the skyline and the smog that obscured it. Smog so thick, in fact, that I could look directly into the sun like Donald Trump during that eclipse in 2017. Everything swam in a hazy orange cast, a combination of red light from the sun and the atmospheric opacity from the general cocktail of Los Angeles air, smog and smoke and ash and pollution and fine particulate matter.
The freeway was strangely empty, only the occasional car whizzing by me, clearly annoyed by either my slowness or the fact that I’d been driving about seven miles with my left turn signal on, or probably both.
It was still, both outside and inside the car. I shifted in my seat, getting a better view of the saturated gradient of sky stretching above me.
There's a before, and there's an after.
Alix was talking about a hangnail. She was also talking about a hero of hers, a man in his 90s with a catheter, late-stage cancer, missing organs and failing eyes, and a spine so broken he could barely walk. But Alix couldn’t seem to tear her mind from that hangnail:
Pain is easy to dismiss in other people. But our own pain has a way of grabbing our
attention and holding it like a vise.
She begins the main story: Devyn, a 14-year-old dancer, is experiencing unexplained, intense physical pain. It starts and spreads inexplicably, seeping its way from the origin point in her hips down her legs to her feet and up her torso to her arms, fraying her nerves and leaving her vulnerable to even the soft breeze of a fan.
Doctors seemed to have only Vicodin and inconclusive tests to offer Devyn, and apparently she was not alone. A dozen voices, mostly those of adolescent girls, chime in to describe their experience.
It hurt everywhere.
Sharp, sudden pain.
You're fine. You're faking it.
You want it.
Gabapentin, hydrocodone.
Sharp.
Fine.
Pain.
Fine.
Pain.
The girls’ earnest, troubled voices vibrate my steering wheel as I try and fail to merge in front of a 16-wheeler. Vivid descriptions of radiating hurt in their nerves and bones and teeth cause me to do a scan of my own body.
It felt paradoxically like the more attention that they gave to the pain, the bigger the pain
grew.
I felt the soles of my feet, swaddled by socks that were too tight, resting against my insoles. The flexion of my ankle as I pressed the gas. The palms of my hands curled around the smooth pleather steering wheel, of perfectly-engineered ergonomic circumference. The dryness of my mouth. The thick air rustling my hair through my skylight.
The palms of my hands tightening around the pleather steering wheel. The dryness of my mouth. The hot, hot air rustling my hair through my skylight. Hot, hot, syrupy air—
Fuck.
“And here's the thing about attention that most of us don't fully appreciate. Attention is not a neutral force.
It invariably changes the thing that it purports to observe. Often, it makes that thing bigger.”
Looking down at the wheel, I remember from driving school that the “ten-and-two” position is actually wrong, and eight-and-four is the correct hand placement. Ten-and-two, in fact, will cause your hands to swing up towards the ceiling like a loose pendulum, ripping your humerus from its socket and leaving your arms limp and dangling from your shoulders as you slump into the deployed airbag.
Yet, despite the lubrication of the steering wheel from my hand lotion and a sudden sheen of clammy sweat, I can’t seem to shift my grip down to eight-and-four in order to hypothetically preserve use of my arms.
Oh no, I think to myself. I’m going to have a panic attack on the 405.
The clock on my dashboard says 4:52. Suddenly, I can feel my heart throwing itself against my ribcage, like it’s trying to force its way out of my body through my chest.
THUMP.
THUMP.
THUMPTHUMP.
THUMPTHUMPTHUMP.
Pull over.
Draw elbow down, hand follows.
Wheel turns, car follows.
Lane divider, lane divider, lane divider.
So many lanes.
Lane divider, shoulder.
I yank the parking brake up and jerk the gear shift. I know that idling on the shoulder like this will only contribute to the particulate matter making the air so oppressively, suffocatingly thick. But I also know that if I turn off the air conditioning, I will melt down into a puddle of salt water and cortisol.
It really was unfortunate, I thought as I strained to force air down my throat and into my lungs, that this was The One. Of course I thought it every time, but I was definitely, definitely dying this time.
What a lame way to go: to an NPR podcast, idling on the shoulder of the 405 on a Tuesday evening.
“... pain is not — at least, usually – an indication that there is something immediate and life-threatening
happening.”
It was too dark to see my face in the rearview mirror, but I could feel its ruddiness as my inner panic stoked what felt like a wildfire behind my skin.
— at least, usually —
THUMPTHUMPTHUMP.
THUMPTHUMPTHUMP.
I couldn’t tell if this ringing was from the podcast still blaring through my speakers or another effect of the panic fire raging inside my body. Was the podcast still blaring through my speakers? And why is the freeway so empty? Isn’t it rush hour?
THUMPTHUMPTHUMPTHUMPTHUMPTHUMP
“He deeply believes that the way that we now ask about pain and treat it like an emergency instead of like a
normal, predictable part of life — that's led to more pain in our society.”
Deaf to the voices coming through my speaker, it hits me: I am going to die. I am going to die. I am going to die.
I wonder if Alix Spiegel knows that her voice was the last thing heard by the 20 year old student who died on the side of the 405 of no apparent cause at 5:03 PM.
I am going to die.
I fumble for my phone, a perfectly accessible means of communication with the outside world, the world I can see through my windshield in the distance, illuminated by clusters of tiny twinkling lights through the smog.
I am going to die — passcode — I am going to die — homescreen — I am going to die — phone app —
“When you're unable to name and think about your emotions and don't have the tools to diffuse them,
whatever stress you experience is directed at and absorbed by the body.”
It occurs to me (much later than it probably should have) that I am, in a way, having a similar experience to Devyn.
This certainly doesn’t feel like an emotion. This is pain. This is a threat.
This is an emergency.
But in a way even more concrete than Devyn’s amplified pain, this was all coming from my brain.
That's why she was feeling pain, even though no test saw any problem. Her brain was stuck on the wrong
setting and couldn't stop paying attention.
Suddenly, I am conscious of the calming, deliberate voice that surrounds me rather than heartbeat in my ears.
I will humor you, Alix. Invisibilia is going to talk me through my inevitable demise, and I am going to let it.
Name and think about my emotions.
Physically — hot and tight and slippery. I feel weak and pliable, like if you tried to grasp my shoulders your fingers would simply sink into my skin like proofed dough.
Emotion one: Panic.
Physically — large and dull and heavy. I feel swollen and trapped, like if I tried to lift my arm my muscles would give out and release it slackened by my side.
Emotion two: Fear.
Physically — sharp and stabbing and acrid. I feel conspicuous and exposed and perceived, like the heat from within is matched by that of a giant spotlight from above.
Emotion three: Shame.
And they all feel endless.
So I named my emotions.
I am still going to die.
Out loud, to the empty freeway and the disembodied podcasters, I heave, “Ooooh God.”
THUMPTHUMPTHUMP.THUMPTHUMPTHUMP.
THUMPTHUMPTHUMP.THUMPTHUMPTHUMP.
What’ve you got for me now, Alix? Devyn?
“Am I going to have to live with this the rest of my life? And if I do, then how am I going to cope with it?”
You’re not, Devyn. You’re not going to cope with it. And neither will I, because I am going to die here, on the shoulder of the 405, at 5:05 PM. I am hot and slippery and heavy and dull and large and acrid and sharp and stabbing, I am panic and fear and shame and I am still going to die I am going to die right here on the shoulder of the 405 at 5:05 PM.
And there is absolutely nothing that Alix Spiegel or your stupid pain program can do to stop it. Invisibilia, I am going to die of “all the invisible forces that shape human behavior, our thoughts, our emotions, our expectations.” And I won’t even get to hear the rest of your fifth season.
Alix is unfazed by my imminent death. She is instead narrating one of Devyn’s last tasks at the program, an easy 15 minute run. Devyn has done much, much harder things throughout her life and throughout this program, but for some reason she begins hyperventilating.
I can't understand why she would be struggling until suddenly I realize she's breathing this way because of
what she's feeling. There are tears in her eyes. She's running, and there's tears. And she's still running.
Alix's tone shifts from detached commentary to genuine wonder.
Eventually, Devyn is done running. Her trainer asks if the run was easy, medium, or hard. Devyn spins around and vomits into a trash can.
It occurs to me . . . that this whole treadmill episode is how they want Devyn to be once she's back in the real
world. They want her to be able to feel her feelings about the things that trouble her. Then they want her to
just push on.
I could easily imagine — and, I felt at the time, though I now say it sheepishly, empathize with — this sixteen year old asthmatic sufferer of amplified chronic pain, in the 14th minute and 55th second of a 15 minute dead sprint, lungs on fire and tears, mingled with snot and sweat, streaming down both cheeks.
At least, I was also on fire, breathing hard, feeling sharp and dull stabbing and aching and heaviness and agony. And I was also very, very sweaty. But the belt on Devyn’s treadmill was still going, and here I was idling on the shoulder, contributing to climate change and slowly spiraling into my own pit of emotional and physical despair.
Perhaps my pain was not an emergency. Perhaps I could push through long enough to be sufficiently okay to puke into a trashcan.
So I released the parking brake, leaving a glistening palm-shaped imprint of sweat. Shifted the car back to drive. And, breaths still shallow and skin still hot to the touch, heart leaping out of my chest, peeled back onto the freeway.
… The ability to explore and manage the thoughts and emotions that you need to struggle with, paired with
the capacity to ignore the thoughts and feelings that will make the bad things in your life grow.
In the same brain that is telling me I am going to die, I could make out the faint acknowledgement that, like every other time, I was not going to die. I was going to return home exhausted, sheepish and disquieted. But I would be alive.
Like Devyn, I would be in pain, and I would be alive.
I am breathing this way because of what I’m feeling.
There are tears in my eyes.
I’m driving, and there’s tears. And I’m still driving.
“Devyn's finally allowing herself to feel and show the emotion that she needs to feel and show. But at the
same time, she doesn't stop. Her feet continue their pounding.”
