Abstract
In 2008, an MRI scan was performed on my lower back after I observed severe pain in my back and left leg. In this article, by means of autoethnography, I explore the multiple meanings of the scan using both narrative and poetry. By taking the MRI scan out of the biomedical context of its production, a space opens up for the aesthetic. In the medical discourse the MRI is purely instrumental—a means of visualization that can help in the establishment of a diagnosis. In my lived experience it becomes poetry—a form of visual poetry that offers a glimpse at my inner self. This aesthetic value seems to be lost in the eyes of a physician. This piece of autoethnography strives to be a recuperation of that value.
In writing from the heart, we learn how to love, to forgive, to heal, and to move forward. (Denzin, 2006, p. 423)
MRI scan of the author
I have a double that haunts my left leg It happens when I sit on my chair It happens when I walk for too long It happens before I go to sleep It happens when I wake up. My double possesses my leg It makes my leg ache It makes my leg tired It makes my leg numb It makes my leg scream For my help But I pretend not to listen. I can see my double all the time But I pretend I don’t know it I pretend it isn’t me I pretend its omens are lies But my leg knows different.
Naked before you, without skin, I invite you in—please take a moment, please take a look. Here I am. Who am I? Shredding myself to pieces of meat—fragmented, multi/vocal/local. My body carries a secret in the depths of my being, in the darkness of my inside. The MRI machine sheds beautiful invisible light to reveal my flesh—it looks like a painting, it looks like porn, it looks like a piece of meat ready for cooking. I am relieved my insides are black and white, and shades of gray. I am relieved my insides are not bloody red. No knife/scalpel has sliced me yet.
MRI Transverse view of the author’s lower back
Do you see inside me? With your X-ray vision Sliced up by a machine. A body to pieces. Of meat. I am what I don’t embody. I do not eat meat. Stop looking at me! Underneath my clothes—undressing me! Underneath my skin—dissecting me! Do you see inside me, slices of meat? I see fantastic landscapes Mysterious geography of inner self. Naked, unskined By a grand machine.
Three Stories and a Constant Intermission
A Story of Pain in Three Intermissions
Life flows like music—gentle waves, in rhythmic succession: breathe in, breathe out, 1, 2, 3 . . . 25, breathe in, breathe out, 1, 2, 3 . . . 25. I flow along myself in rhythmic succession, undisturbed, bending, stretching, and lifting. The music stops. Static. Louder, louder, louder! The flows of light become sharpened, pointy structures of darkness. Stop. In static nothing flows—just a chaotic movement of no purpose. Intermission. “While in a sense the body is the most abiding and inescapable presence in our lives, it is also characterized by absence” (Leder, 1990, p. 1). My body flows along myself. We flow together, in rhythmic succession, the flow of life. Trusted companion, in silence you sing with me the dance of life. Dys-apperaing you shatter my world—you want to sing your own song now, and your many voices are stronger than mine. I do not know how to dance this dance with you; I do not understand the rhythms. I hear only noise. Static. Louder, louder, louder! Will I have to fight you, my trusted companion?
Intermission 1
I am an undergraduate student, 20 years old. I live in a dorm and I share a room with four other girls in the prime of our lives. Finally away from home. Away from everything. It is beautiful outside, early spring, just after the first of May. We all went to a picnic on the first of May—not only us but the whole town—to a nearby forest. We had a nice time, but now I have to do some washing. As I bend over to pick up the washing basin I feel a sharp pain in my back and going down my left leg. Oh no! I can hardly step on my leg! Strokes and strokes of pain. Louder, louder, louder! The rhythm disrupted, the washing abandoned. I limp back to my room and rest on my bed, not knowing what to do and hoping that it will go away. This has never happened before! I must go to the campus doctor. I explain what’s wrong and she sends me to an internist who refers me to a rheumatologist and prescribes shots of vitamin B. I try to see a rheumatologist at the city hospital, but the waiting list is just too long. After several attempts, I give up. I stay mostly in bed, hardly getting up to go to the bathroom, or to go to the campus doctor for my vitamin B shots. Very long days of doing nothing, just waiting for the pain to go away.
After 10 days, the pain finally gives way and I forget about the whole thing as I regain my rhythm.
Intermission 2
I am walking home from the groceries store with my mother. I argue with her about letting me carry the bags. She gives them to me eventually. We cross the street. Oh no. It’s that pain again! Static. Louder, louder, louder! And I am still on the pedestrian crossing. I manage to get to the sidewalk in the end. But I can’t step on my leg and I can’t walk home. We phone my brother to come and take me in his car to the emergency room. My mother goes home with the bags of groceries. I wait on the sidewalk for my brother, feeling a bit silly just standing there. I feel like people are looking at me and can tell that something is wrong, that my rhythm is gone. Finally my brother arrives and we go to the emergency room where I get a shot of painkillers. Back home my mother irons my back (with a clothes iron over a blanket—my father used to iron her back when she got stiff and tired from all the house/work) and tells me I should rest. By evening I feel much better. The pain is gone.
Intermission 3
It’s autumn, and I just started my M.A. studies. I have classes from 4 o’clock in the afternoon. It’s about lunch time and I decide to prepare something to eat: pasta with tuna and corn. I live in a better dorm now. I share my room with only another M.A. student. My room is on the seventh floor and I have a great view of the city. Ok it’s time to drain my pasta. I bend over the sink. Oh no, not again! Pain in my back and leg! But what did I do? It all seems very stupid to me. And the pain is much more severe than the last times. I must go to the campus doctor again. I ask her if she can send me somewhere close because I can hardly walk. She writes a referral for the neurology clinic. I can see the building just outside my window. I go there to the emergency room. A very nice doctor examines me: he tells me to stand on my toes, and on my heels—I can’t do this last one; he asks me a lot of questions. I explain that the pain is sharp and going down my leg and I tell him this is not the first time it happened. He gives me painkillers; he tells me I should rest in bed for a week and sends me to get an X-ray done. After three days I return with my X-rays but they don’t show anything suspicious. As my pain doesn’t seem to give way, I am given some stronger painkillers. Red and blue, big and small, these ones look like precious stones—they shine with beauty. Just drink a glass of water and they’ll do their job. They can silence the noise, so you can feel the rhythm again. You don’t seem to like this, my trusted companion, you don’t want to swallow diamonds: I vomited the tiny red seeds of a pomegranate. I should get an MRI scan.
I am pretty excited to get an MRI scan, like in the movies I’m thinking. I’ve always been in awe of medical technologies. I go to the clinic, 1 hr earlier as I was told to, and sit in the waiting room until it’s my time. The waiting room is in the basement of the building, and there are a lot of people waiting for an MRI or a CT scan. An emergency is brought in, a lady on a stretcher. She seems badly injured and is rushed into the CT room. I start to feel a bit anxious and lonely—I should have asked someone to come with me. Finally a nurse calls my name and I go into the MRI antechamber where I leave my purse, my jacket and my belt. The nurse asks me a few questions, and tells me to sit on the patient table of the MRI scanner; put earphones on; sit very still, you need to be very still while we take the scan, it should take about 20 to 30 min, you will slide out when it’s over. It’s like standing still for a 20-min picture shot. You have to be still if you want to look great! The tube they slide you in is very narrow and the noise is very loud. I hope I’m being still enough. I wonder how this works. This tube is very narrow. How much longer? I’m glad I’m not claustrophobic, this tube is very narrow. How much more does it take? Ok, it stopped, I’m sliding out. The nurse comes and tells me I’m done, I can go now and I must come tomorrow for the results. When I go after the result, I receive a CD and a letter in an envelope. I quickly read the letter to see that a doctor I have never seen, but whose name and stamp are at the bottom of the page states that there is a protruding disk between vertebras L4 and L5. It all seems very logical to me. That is where my pain must be coming from. In a sense I am relieved—now we can do something about it, now they know where the problem is and something can be done to solve it. I take the MRI scan to the doctor who before looking at it says that it’s probably nothing. Then when he reads the letter says “Ow! Let’s, let’s see”, and inserts the CD into the computer. Aha, there it is, that black spot! It’s possible that I may require surgery. The pain doesn’t seem to matter anymore, the MRI speaks of deeper truths. But my pain was beginning to give way. And the prospect of surgery just terrified me. I was living in a town away from home. My mother was burdened enough by the problems at home, I just couldn’t imagine telling her that I needed surgery—and all because I was not careful enough. My mother expected I could take care of myself. But I also couldn’t imagine bearing through this on my own. I couldn’t picture anyone from my friends or even my boyfriend as a willing and full-time caregiver that could help me through this. I just didn’t think I had the personal or social resources necessary for going through what for me seemed like a major interruption in my life. This is not a very good time to have surgery! But is there such a thing as a “good time” for something like this? Pain and illness, being contingent, disrupt plans and projects and lives. “You are always surprised” (Frank, 1991), and never fully prepared I might add.
Under the powerful gaze of a grand machine, you reveal your/my/self. To pieces. Body-machine for 20 minutes. Extract from me, my deeper truths. Reveal myself to me/others. I feel your gaze entering me—phallic machine I slowly slide into your womb—a narrow, noisy place. I am a passive object for your invisible knifes slicing me to pieces in black and white snapshots. Naked to the bone. Your gaze created my double, to haunt my dreams and my leg, to speak louder than me, of deeper truths, to speak beyond me of some sort of essential flesh. Thank you, now they/I/eye can see my pain!
With the help of a friend who is studying medicine I am going to see another doctor to get a second opinion. My friend insists that I do this even though I am not so sure. But I accept in the end. This time it is a neurosurgeon. There are a lot of people waiting at his door and I feel like I am trespassing. Finally, I am smuggled into his office. He is sitting at his desk and asks me what my problem is. I explain that my back hurts and the pain shoots down my leg. He asks me if I feel any numbness in my leg, and I respond that no, I don’t. (The numbness would come later on, after I tacitly decided not to do anything about my back, to just let it be, hoping that it would slip into silence again.) I tell the doctor that I had an MRI of my lumbar region and hand him the CD. He puts it into the computer and looks at it. He then turns to me and says that there is a disc protrusion pressing on my nerve root that is causing the pain, “but, he says, you’re too young, I wouldn’t want to start on you, I recommend some physiotherapy first.” I feel a bit relieved as I walk out of his office. I am 23 years old.
Between surgery and physiotherapy I choose the last one. It’s more familiar, I know there is nothing to be afraid of there. And so this last and more severe crisis passes ok. And I let it pass, trying to forget about it.
“Stand Up Straight!”
I am 14 years old. It is summer, and summer means holiday. No more school, no more homework, no more waking up in the morning. “Stand up straight!” I hear voices all around me telling me not to slouch. “You have to stand up straight, to be a beautiful young lady.” It was decided, I should go to medical gymnastics to improve my posture. But it’s summer, and I can’t stand the heat. Do I really have to do this? Yes, there is no question about it. Ok then, I’ll wake up at six. Everyone in the house is still asleep; I have to be very quiet and sneak around to the kitchen, to the bathroom, get dressed and walk out the door. I walk through the summer morning almost empty town. It’s cool outside. I am wearing shorts and a light jacket. I arrive at the town’s hospital at 7 o’clock sharp. I walk up the stairs into the main hallway—to my left I can see people lining up for blood tests. I go straight ahead and down the stairs to the basement where the gymnastics room is. Sometimes I arrive there even before the physiotherapist, a rather strict lady with red hair and glasses, does. I am so proud to be the first to arrive. I take off my shoes and my jacket and I start the exercises. It takes me an hour to complete them all: 1, 2, 3 . . . 25, rest for a bit, then again 1, 2, 3 . . . 25, then again rest. I start with a set of exercises that I do with the help of a meter long wooden pole in front of the mirror, constantly monitoring my posture. My father brought this pole for me and I also have one at home. Ok I’m done with those, I now go and sit on the mattress. It is sunny outside. I think it’s going to be a hot day again. 1, 2, 3 . . . 25, rest for a bit, then again 1, 2, 3 . . . 25. It is easy to do sit-ups. It is the back extensions that give me a hard time. I don’t like doing those and I really struggle with them. After a couple of more exercises I’m done and I can go home. Because it’s summer, I go home and sleep for one more hour. But then, in September, school starts and I can’t go any more. I do some of the exercises at home for a while. But I still seem to slouch. More summers after this I spent in the same way. I think the last one was in high school. But that was a little different than the others. My father was getting ill—he developed heart problems—and after doing my usual exercises in the gymnastics room, instead of going home, I would go to the cardiology unit for the in-patients, and spend the rest of the morning with my father. A few years later, while I was in my last year of high school my father passed away after suffering a heart attack.
This Is Not Just About My Posture
I am 24 years old. It is spring. After a long winter that we thought would never end, it’s finally spring. “Ok, says my boyfriend, I’ve talked to him, and you need a referral from your GP and you can go to physiotherapy.” I don’t remember asking for this. Did I ask for this? It makes me anxious. I don’t like going to the hospital. I get very nervous and I take it out on him. I’m so sorry. I’m such a horrible person. But he is late. We are supposed to get there at 8 o’clock sharp. He knows I hate it when he’s late. We get there in time, and I feel bad for yelling at him like that. We meet the doctor, my boyfriend’s cousin, and he tells us we have to wait for a while. The hospital is a massive eight stories building and I have to climb 20 min up a hill to get here from where I live. We are waiting in the main hallway of the building. There are other people waiting here and medical students going in and out of their wardrobe. Ok here he comes, the doctor. We are going up to the seventh floor where we meet a nurse and we are told to wait in a room she opens for us until I’ll have to go to another doctor who is going to establish my treatment plan. The room we have to wait in has a very nice view and because it is sunny, it is getting very warm. I have to open the window. As we are waiting in the room for the nurse to return, I remember I forgot to bring my MRI scan. I left “my double” at home. How could I have done this? How could I just forget about it like that? That scan is like my identity card. We don’t have time to go and get it as the nurse should come back any minute now. I guess my body and my words will have to do for now. I’ll bring it with me tomorrow. Finally I go to the doctor. His office is very small and crowded with books and it’s not sunny at all, because it’s on the other side of the building. He takes my referral and asks me a couple of questions about my problem. I tell him I have an MRI but I forgot to bring it. He seems a bit angry at my forgetfulness. I try to make it better by telling him that I can bring it later on today, or tomorrow. He tells me to undress. I should remain just in my bra and underpants, and then lay on the bed. I do exactly as he says. Before he starts examining me an intern comes in to assist. The doctor tells me to say when I feel pain. He takes my legs one at a time and raises them as high as he can before I say it hurts. I feel like a clay puppet. How could I forget my double at home? It can speak better for me. It has done so before. The doctor tells me I can get dressed now, and tells me that I probably have a lumbar disc lesion. He makes a treatment plan for me: massage, ultrasound, interferential currents, gymnastics. . . “Do you have any leaks?” he asks? The question seems odd, but I understand what it refers to and say no. “Because I want to put you in the swimming pool for aquagym.” The next day I bring him the MRI. He takes a look at it and says, “Well, let’s hope this works.”
So here I am again. I wake up at 6 o’clock. I hurry to get ready, don’t forget my swimsuit and my towel, and walk 20 min up a hill to the hospital. I have to be there at seven or I’ll never get all my procedures done. There are a lot of people waiting at different doors. The first one is massage. Then it’s interferential currents—I’ve had this done before a couple of summers ago, when my mother took me with her to a friend of hers who was a nurse back in my hometown. Then, if I have time I get the ultrasound done. But I won’t have time. There are too many people waiting in front of me. All this waiting I have to do makes me tired. And then some people don’t respect the line and start fighting. It’s too much tension. The aquagym I like the most. There are 15 of us, women getting into a pool with water just up to our necks. And we do the exercises that the instructor, a nice young man with a sense of humor, tells us to. When I get out of the pool my body feels very heavy, but I quickly readjust. After doing these four procedures, I have enough time until 2 o’clock when I go to gymnastics to go to my boyfriend’s house (he lives closer to the hospital, just 10 min away) to eat and maybe get a half an hour nap. By the end of the second week I was starting to get really tired, and my leg seemed to hurt even more than at the beginning. And I hardly got any reading done for my PhD during this time. I was somewhat glad when it was over.
***
Constant intermission
I can’t sleep. Something is bothering me. I twist and turn. I finally realize it’s my leg. It hurts a bit, and it won’t leave me alone. I start to worry trying to find a suitable position. I just can’t sleep. I see my double and its omens are bad. The black spot. It’s inside me. I must do something. If only I could go to sleep. Do I need surgery? What if my leg becomes paralyzed, engulfed by the black spot that grows bigger and bigger and bigger. . . No, don’t think about that. Think of something else. If only I could go to sleep, things would be ok in the morning.
I wake up. I’m lying on my back. I don’t like to jump out of bed right away. I like to snooze for an extra 5 min. Now I really have to wake up. As I am more fully emerging from sleep, I start to realize that the toes on my left foot are a bit numb. It doesn’t strike me as odd at first. But as I grow more aware, it starts to seem odd that the toes of my other foot are not numb. Again a shadow of my double passes by. It’s the black spot! It is making my toes numb. I grow more anxious as I try to wiggle my toes to make them come out of their numbness. I beg them not to let the black spot of my double engulf them! They finally answer my prayers. I must get out of bed, and get ready to go to the library. I have some reading to do.
I am walking up the hill after a long day. I can’t wait to reach my room and lay down. All I can think of is the elevator. I hope it’s working. Oh please be working. I don’t want to climb seven flocks of stairs. As I get nearer to the dorm, I become more and more aware of a strange tiredness in one of my legs. It strikes me as odd that it should be just one leg. And then I see my double pointing at my left leg. It’s the spot, trying to engulf it, to engulf me!
As I write, sitting on a chair at my desk, strokes of pain go down my left leg. It is not an unbearable pain. It resembles a noise, like someone drilling in the building across the street from you. A noise that you’ve grown accustomed to, and learned to ignore in order to concentrate on your writing. Nonetheless, from time to time I feel the urge to readjust my position hopping that the pain will give way.
“Critical voice”:
It is your entire fault. All of this. For not keeping up with the exercise program. You would find various excuses: lack of time, lack of space. The truth is you never wanted to listen and you were and still are lazy. You are not willing to put some order in your life. To be disciplined. You can never keep it up. If you exercise for a week or two it won’t be enough! You need to make this a part of your daily life. You are passive about this. And when people ask you, you would rather say that everything is ok, that you are much better now, to hide the fact that you are not doing anything about it. You brought this unto yourself, and you are still not doing anything about it. And it won’t get better by itself, you know, the black spot on the MRI won’t just disappear, as the pain occasionally reminds you. You should get scared when you wake up in the mornings and your toes are numb! But you should do something about it! This critical voice imputes my lack of self-control and blames me for my troubles. The body is something to be controlled through programs of exercises and discipline. This critical voice is the voice of my mother, of my boyfriend, of my friends, of my sociocultural context, that perceive the body as something that needs the careful monitoring and control of the rational mind. The failure to do this is posited as moral failure—I am irresponsible and immature. Despite trying to resist this moral imputation, by insisting that I am not really ill—“it’s just this back”(Lee-Treweek, 2001), in my darkest moments of anxiety and fear I also blame myself for the weaknesses of my body.
MRI Sagittal view of the authors’ lower back
***
My body flows Along myself. Darkness and grayness and light— I can stand. Flows of verticality, structures of life/light. I see a deeper self, Hidden under my skin. I see flows of pain and (de)light. Flows of verticality, structures of life/light.
Together
In the messiness of my body, I know you are lurking, waiting. A menacing darkness of my own making. You are waiting for my next mistake: sitting in an uncomfortable seat at the theater; a plane ride for two hours; a walk across the bridge to Ukraine. No one knows you are (t)here. Invisible. But I have seen you, under the powerful light of a grand machine. I know you. I feel you. I am prepared for you. I know your possible strikes: a bicycle ride, waiting in line, going for a walk, cleaning the house, doing laundry, cooking, having sex, sitting at my desk, writing this. We are one. Constant companion. You are faithful to me, putting up boundaries, from the inside out. “I’m ok” I say. “I’m just a little stiff, the chair was uncomfortable”, I say. You are my secret. Unrevealed. In the eyes of others you are nothing, you don’t exists. My body, you are silenced. You mustn’t say anything. I am tired of keeping you at bay. Lurking. Come take me already. Better now, than later. Why are you sleeping? Why do you make me doubt you? I easily forget: “I would like to go to all those beautiful places—the frozen fields of Siberia, the rocky peaks of Himalaya, the lush forests of the Amazon,” I said. “But I would like to leave my body behind, this burden” I said. He looked at me and didn’t understand. I didn’t know what I was saying. I would have liked to leave you behind. I didn’t know what I was saying. By writing about you, I do not see you anymore. I see myself. Lurking, waiting. I am so many things, and yet I am one. Embodied. Enworlded. I’ll take you with me now, wherever I go. Not a burden, but a facilitator. I will burden you, as you must carry me across the fields, and up the hills. You will ease my passing and remind me of myself.
Footnotes
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The writing of this article was supported by Investing in people! PhD scholarship, project co-financed by the Sectoral Operational Program For Human Resources Development 2007-2013 Priority Axis 1. “Education and training in support for growth and development of a knowledge based society” Key area of intervention 1.5: Doctoral and post-doctoral programs in support of research. Contract nr.: POSDRU/88/1.5/S/60185—“Innovative doctoral studies in a Knowledge Based Society” Babes-Bolyai University, Cluj-Napoca, Romania.