The Silent Weight of Pain
/By Dr. Yujin Kim
Pain is an intensely personal experience, yet its perception by others varies widely. It exists on multiple levels — physical, emotional, and psychological — and each level influences the others in profound ways. Some pains are fleeting, while others shape personalities, behaviors and interactions with the world.
The disconnect between personal suffering and external perceptions of it highlights the isolating nature of pain, reinforcing the fact it is often misunderstood, dismissed, or ignored.
Pain is invisible, unless it is expressed through noticeable behaviors such as crying, grimacing, or changes in posture. Yet these outward expressions are unreliable indicators. Some people endure excruciating pain in silence, while others react to even minor discomfort. This variability often leads to misjudgments — some assume pain is exaggerated, while others may underestimate its severity.
Chronic pain, for example, often goes unnoticed by caregivers, colleagues and even close friends. They may assume that if pain isn’t outwardly expressed, it doesn’t exist.
However, there are rare instances when someone recalls a pain that the sufferer has long forgotten. I experienced this when a colleague reminded me of my wrist pain long after I had moved past it. Pain leaves an imprint, even when we no longer actively feel it.
Pain is not merely a sensation but a transformation of the body’s posture, movement and personality. These behavioral shifts serve as survival mechanisms, signaling distress.
Common pain-related behaviors in both humans and animals include grimacing, furrowing brows, clenching jaws, hunching, guarding affected areas, rigidity, irritability, withdrawal and sensitivity to stimuli. Physiological responses such as sweating, paleness and rapid breathing often accompany these behaviors.
In my work as a veterinarian, I’ve learned that animals, like humans, express pain in subtle ways. A turtle in distress may show tremors, ataxia, or anorexia — signs that can be easily overlooked. Similarly, pets may become clingier or more irritable, a change that can be wrongly attributed to mood rather than discomfort. These behaviors highlight the often-overlooked nature of pain, emphasizing the need for careful attention and understanding.
My Personal Journey with Pain
Pain has been a constant companion in my life. Childhood injuries — from a crushed pinky to an ankle caught in a bike wheel — were my first introduction to physical suffering.
As an adolescent, a car accident left me with a broken pelvis, and the pain was so overwhelming that even my high school math teacher noticed my hunched posture and pale complexion in the last row, taking me to the ER.
Adulthood brought its own challenges — whiplash, fibromyalgia and chronic pain. One day, I lay in bed feeling as though my skin was on fire, my organs shrinking into ash. It was as if my soul was stuck in my body, like a prison with no exit. Despite exhaustive testing, including a radioisotope bone scan, the cause of my chronic pain remains elusive, leaving me to navigate this enduring struggle largely on my own.
One of the most defining moments in my pain journey came with my experience of Nutcracker Syndrome, a rare vascular condition in which the left renal vein is compressed between the aorta and superior mesenteric artery. This caused relentless left lower abdominal pain, heaviness, and severe menstrual cramps that made even basic daily functions exhausting.
The pain was so excruciating that it caused nausea, with waves of sickness rolling over me with each deep breath. Unlike many who endure years of misdiagnosis, I was fortunate to have Mayo Clinic doctors, who reviewed my case comprehensively and ordered the right contrast ultrasound to confirm the condition.
Treatment, however, was another challenge. I sought relief through various approaches — acupuncture, rectal adjustment, and conservative management strategies. Each treatment provided momentary respite, but never a lasting solution.
Eventually, I was presented with the option of a surgical procedure to alleviate the compression in my renal vein. The day of the scheduled intervention was supposed to mark a turning point, a chance at relief. Yet, as I lay on the hospital bed, preparing for what was meant to be a minimally invasive procedure, fear consumed me.
My doctor, though confident, was not a surgeon by training, and a flood of worst-case scenarios rushed through my mind. At that moment, I made a choice — I removed my IV, excused myself, and walked out of the hospital. I still wonder if I made the right decision. The pain remains, but so does my fear of complications.
Managing Pain: A Fragile Balance
Years of managing pain have taught me resilience. I’ve developed strategies to regain control my pain, such as prioritizing rest to minimize flare-ups, avoiding inflammatory foods, engaging in daily physical therapy, cardio, and stretching routines, and training my nervous system to reduce pain perception through central desensitization techniques.
These practices have allowed me to function with a sense of normalcy, but pain’s insidious nature remains ever-present. The absence of pain, even briefly, reveals how much it once defined my existence. The fear of its return is a constant reminder of the weight I’ve carried.
Pain is solitary. No one else can truly feel what you feel. Others may attempt to relate, assume, or empathize based on their own experiences, but their perceptions are often unreliable.
Caregivers, no matter how well-intentioned, may dismiss, underestimate, or misinterpret a loved one’s suffering. The stereotype of the “grumpy old man” captures this well — long-term pain often manifests as irritability, dissatisfaction or withdrawal, which can be mistaken for mere moodiness.
One of the most profound realizations about pain is that we often do not recognize its full weight until we are free from it. When pain subsides, we gain clarity on how much it shaped our existence. Walking away from pain — even momentarily — reveals just how much of a silent weight and burden it was.
Pain is a complex and evolving experience — sometimes noticed, often ignored, and frequently misunderstood. It is deeply personal and, at times, isolating.
While external validation can offer comfort, true relief comes from understanding and managing pain on our own terms. The journey with pain is ongoing, and so is the pursuit of healing.
Dr. Yujin Kim, DVM, is a general veterinary practitioner specializing in exotic medicine and telemedicine at Summit Dog and Cat Hospital in New Jersey. She also advocates for chronic pain awareness, drawing from both her medical expertise and personal experiences.