Written from memory in Portland, Oregon, 4/23/26

Americans in extremis suffer hugely. This is the price we pay for luxury. In 1998 I heard a medical study read over the radio by Doctor Dean Adel, in which he noted that American surgical patents required 10 times the pain medication as Vietnamese patience. Those Vietnamese people grew up as our Greatest Generation managed the firebombing of their nation and the Great Commy Generation managed the psychological torment of their minds.

When people in my family are in a lot of pain, they often consult me as the expert on it, as I’ve been crippled with back injuries twice now and have been beaten with sticks as often as a back-sassing British sailor of Bligh’s era. What I have found is that pain among people who fit the following categories is physically more severe, and also causes more psychological distress:

1.) Women do not handle pain well, with the sole exception of Deb Johnson, who has goon levels of pain tolerance. There are various reasons for this, including higher body fat ratios and the fact that women, as the nesting half of the species, the nursing half, seek comfort for all as an instinct, and are always able to find maximum comfort in postmodern First World circumstances.

2.) Recreational drug users have low pain tolerance, meaning most of America.

3.) Medicinal pain controllers, meaning people who routinely use aspirin, acetometaphin, etc., and now medical weed, have lower levels of pain tolerance.

4.) Folks who have not practiced pain tolerance such as in bodybuilding, distance running and martial arts training, suffer more.

5.) White collar folks who have not experienced a career of hammer smacked thumbs, callused and blistered hands, early osteo athritis, on the job injuries, have low pain tolerance.

6.) People who have not been hit or grappled a lot in combat sports have low pain tolerance.

7.) Fat people have low pain capability, and actually suffer more pain for various physical reasons.

8.) Those who have not slept on floors, side walks, wrecked couches and other uncomfortable circumstances, have low pain capability.

9.) Older folks experience more pain, as it takes vitality, strength, to weather extreme pain and function. My own pain tolerance is about half of what it was 20 years ago, and Mom is 24 years older than me. This placed her at maximum pain levels. For instance, lacking the muscular strength to get out of a painful position, is a terrible straight for a frail elder.

10.) Finally, people who have exhibited a high level of control over their working life, once rendered helpless physically, suffer more mental distress. This happened to the toughest soldier of the Civil War, Nathan Bedford Forest, who was shot in the spine and lifted the soldier that did it as a human shield and rode back to his men. In his end days his pain tolerance evaporated. I have found much of my pain tolerance amplified when disabled by the fact that I have spent my life as a loser, bullied by bigger boys, cruelly treated by bosses, medical gatekeepers, women, middle class whites and low class blacks for the failure to thrive as a white man. Laughed at by family members and made to sit at the children’s table as the eldest man in the family, has shone me more low status enhanced pain than most people experience. The modern woman, especially a white collar, managerial, white woman, has more moral authority in America than the President of the United States. For such a person, used to broad-based moral support from an entire nation, an entire global celebrity culture lionizing the social superiority of the woman in every movie and most books, to suddenly be treated like a homeless tweaker man is to be saturated in a well of social pain, of emotional distress, that makes dealing with physical pain difficult.

When the news came that Mom was in dire health straights, I new she would be suffering, as the quavering voice over the phone had indicated. I arrived at the hospital to relieve my brother, who had been relieving our sister. Not only did Mom have better health insurance than the other patients on the floor, she was the only one with family present. Her situation in the hospital and the rehab facility was infinitely better than her fellows.

I spent one night sleeping on the bench and chair in her larger portion of the shared hospital room, and then sleeping on the floor in the very best suite at the rehab center. Each night I slept less than an hour, as her pain levels were so high, that she needed to be repositioned often.

In the hospital, I was impressed with the high quality of the nurses and techs, but not the doctors. My brother almost beat down one doctor for forgetting to adjust pain meds in the written order. The entire staff is terrified to administer pain meds. For instance, across 5 nurses and two facilities we had the problem of the 2.5 and 5 gram pain dosage. Mom’s pride in control and her belief that pain meds were bad, moved her to refuse a 5 MG and take the 2.5. An hour later she was in agony and the nurse did not have the latitude to give the other 2.5! In medicine 2.5 plus 2.5 does not equal 5!

The above situation explains the massive die off during Covid, when family advocates were barred from hospitals. If Mom had been alone, like ALL of the other 48 patients, she would have shivered in terrible agony for days and then been drugged into oblivion for days, in both states unable to make decisions on her own behalf. The staff, particularly the physically strong and respectful men and women from Africa, gave much better care to Mom, because we were there, than they did to the others, who got standard care, but not extra visits. Also, the fact that my sister and I were diplomatic and Tango was commanding, and all three of us willing and able to help lift Mom, rather than the nurse or tech having to go hunt a coworker, made Mom’s care much more eager to come to her aid, having assistance on hand.

There is the other, institutional cruelty to consider. It is well known by those who have been sick and injured that pain and injury is worse at night. Also, most of those we know die at night, mostly in the early morning hours. Despite these facts, that hospitals and hospices should be staffed 60% night and 40% day, they are staffed 90% day and 10% night! These places are not healing centers but killing stalls. When your loved ones are cosigned to these grim abodes of departure be certain you spend the night. I did have one good moment with Mom.

In the shivering gripes of her agony, once I had gotten her sat up and her neck braced and Francis the Nurse has brought her pain meds, she heard the various women on the floor calling like ravaged norns. For most of the patients were women, and all of those who called out in pain were female. Next to her was a not very sane stroke patient, a woman of about 70, who could not work her buzzer, had no family, and was asking through the curtain for us to help her.

Mom said, in the 2:30 AM gloom, “Go see what she needs.”

“No,” I said.

“What?” she started up in low dungeon.

I stood at attention, “I don’t do that. She’s not mine. If she was bleeding out on the sidewalk I would walk around and not even call an ambulance. I’ve done it many times, refused care to strangers.”

The woman heard this, peeped, and grew silent.

Mom looked up, aghast that she had spawned such a fiend, “You know, you are a Neanderthal!”

I grinned and saluted, “In this pit of despair, my knuckles only drag for you.”

She rolled, then closed, her eyes, “Good Lord…” then shivered in pain and thankfully found a semi-conscious place among the vaulted columns of Saint Karen’s Cathedral of the Eternal Matriarchy, a feral barbarian soul, standing by her side watching FightSport Network as the anonymous feminine sirens of pain whimpered beyond the curtain and down the hall, their empire of Should sinking into the pitiless shadows of IS.