There is a lot of pain when we are injured, break a bone, or have surgery. This happened to me recently and really shook me up. I slipped on an icy walk in mid-winter and landed on the heel of my left wrist — my guitar fretting hand — breaking the radius bone clean through. Without knowing anything about treatment options and recovery for distal radius fracture, I elected for open reduction internal fixation surgery, where a titanium plate was screwed into the bones.

I was 61 years old with 30 years clean and sober and I had never had general anesthesia before, had never even broken a bone. I worried about feeling pain but also worried about the effects of anesthesia drugs and post-op pain medication. I knew a handful of ex-alcoholics and addicts, maybe a dozen, who became addicted to pain meds and suffered terribly. I was immediately honest with my surgeon and he prescribed what he called a non-opioid (Tramadol) for post-op pain. It’s actually a synthetic opioid and a controlled substance, but the surgery was successful and I took the medication at the lowest possible dose to control the pain for just five days after the surgery. I didn’t crave its effects and managed pretty well after that with over-the-counter meds. There was nothing I could do about the anesthetic (Propofol) I was given for surgery. I wanted to be completely unconscious!

But in the next few weeks, I was weepy and often overcome with anxiety. I don’t think it was the medications (who really knows). It was my mind, for sure — I was terrified of falling again, alone and without help. I had anxiety over asking for help, fear of the future, and, above all, fear of pain. I was not used to that kind of anxiety or its intensity. I could not drive but I had help from friends, ordered groceries delivered, and watched a lot of Netflix.

Before I went back to work I tried to keep my creative mind active. I read a volume of Billy Collins’s sweet, wistful poetry, and wrote short poems almost every day. Most of my writing was about the fracture, and fear, of course. I slowly realized that the lessons I was learning about my wrist fracture I had already learned long ago and somehow forgot. They had applied to the invisible, ravaging injury of the early days of withdrawal from alcohol or drugs, even to the days or months leading up to getting clean, when the broken parts were almost all under the skin and in the mind. Some say in the spirit, as well. There is a lot of pain in recovery, at first.

Lesson number one. It takes time to heal — more time than we think it should and more than we want it to. There is and will be pain as we heal. Even weeks, months, and years later the pain flares when we make a wrong move, even when we make all the right moves. Sometimes it just flares on its own as the sensitive skin, bones — even thoughts — recall the injury. Sometimes it comes as a sudden stab, sometimes it’s a nagging ache.

Addicts are in a big hurry to alter discomfort and avoid it, which is ironic considering that doing the same thing got us the same results. It would be nice if abstinence marked the end of the pain. It would be nice if we never had to move that painful broken limb again. But, no.

I began physical therapy at 6 weeks post-op. I could not stop myself from crying during my first couple of sessions. It was more than pain. The bones were healing perfectly but I was emotional. I was stretching emotional muscles that had stiffened as much as the tendons in my wrist, hand, and fingers. I was afraid. What if I could never play guitar again? What if I had permanent nerve damage, what if the surgeon missed something? I was crying over the present pain but also future fear and past hurt.

Lesson number two. Fear can settle in like a bad roommate who uses our things without asking and leaves a mess for us to clean up. Even in long-term recovery, we may become afraid of making a wrong move, afraid of reactivating the pain. To avoid pain maybe we stop moving altogether and lock ourselves in with the fear, afraid to fail, afraid to fall. And maybe we fear that we’re permanently broken — that we’ll be unable to dance, run, build, carry a child, make art, or play the guitar like we did before.

I had developed complex regional pain syndrome (CRPS) from the weeks of immobility in the splints and cast. I had loss of sensation and a lot of swelling in all of my fingers, really the entire hand, but it was worst in my thumb. I could not move or bend it without pain. My first excruciating attempts to pull up my pants, twist a door handle, pick up my cat, and hold my guitar were very much like the early years of recovery when I accomplished sober firsts — first relationships, jobs, financial decisions, hell even driving past the bar — all terribly uncomfortable and requiring faith in myself no matter the outcome.

The CRPS has gotten much, much better but I still don’t know if or when I’ll overcome it. Fifteen weeks after surgery I could play guitar a little and I resumed the writing I was doing before the break, starting with an essay about being stalked by my next-door-neighbor 20 years earlier. It dawned on me that the lessons of pain applied to this kind of post-trauma recovery, too. Victims of stalking know that fear becomes a shadow which follows us into the future, dragging minor harassments, medium trespasses, and major abuses from the past along with it. We become suspicious and hypervigilant, seeing danger everywhere, maybe painting ourselves into a corner with a very broad brush. Even years later, maybe we recoil at the slightest chance of being frightened or hurt again and cling to what resembles a sense of security, even if it isn’t healthy.

And loss can be a pain-to-fear trigger: the death of a loved one, divorce, financial insecurity, or homelessness. Maybe we blame others or maybe we blame ourselves. Maybe we lose ourselves. No one is immune from experiencing loss, but the mind of an addict seizes on it as a calamity requiring fight or flight, and looks for control in oblivion or assigning blame — dangerous precedents to relapse. I learned these lessons, too.

But, unexpectedly, maybe we find reserves of strength and endurance we didn’t know we had. This has happened to me several times over the years and I have found it possible not to drink and drug despite my darker-leaning expectations.

Lesson number three. Precisely because we are healing, we can support others in unexpected ways. As we witness the honest vulnerability revealed by others in recovery, we will gain compassion for them and for ourselves. Compassion will make it possible for us to become open to our experience, even to look at the past without staring at it, and to understand ourselves. We will find that we have it in us to see ourselves in others and to help almost anyone.  

Lesson number four. In recovery there is always more to work on, or to work out, to press past, to stretch through, to regain or to accept as gone. There is always more to discover about ourselves and this life. The practice and tools available in many programs of recovery offer a kind of physical and occupational therapy. We heal, we change. This, too — whatever it is — will pass.