The Unknowability of Other People’s Pain

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Late every Christmas Eve, he’d tell me about it again. Eight-year-old P.J. had stepped on an old can that cut through his tattered shoe. The puncture wound became infected with tetanus — fatal even now in 10 percent of cases, far more so in rural Ireland at midcentury. The closest hospital was hours away, and no one in my father’s fishing village owned a car. Finally, some wealthy man came to drive P.J., but too late: In the back seat, his body already stiff and jaw locked, P.J. died, rigid, stretched out on the laps of my 13-year-old father and his father.

Every time my father told the story, I’d find myself looking out of his eyes, down at his dying little brother, only 8 years old. P.J.’s body had become his coffin. That must have been so terrifying. My father must have felt so helpless.

From helpless boy, my father grew to intimidating man, in part through determination. He’d had no control over P.J.’s death, and not much over my mother’s. And yet the rage his powerlessness engendered became a motivating energy that transformed into physical strength. He managed to work so hard and so steadily, to be so self-denying and steadfast about saving money, that he paid my way through an Ivy League college.

His strength may have proved itself most of all, however, in the way he endured his physical suffering for so long. By the time he reached his 70s, he was constantly, unpredictably sidelined by stomach upset or bowel trouble, which no doctor could adequately treat, or even diagnose. The intractability of his maladies should have made me more concerned about him. Instead, he became the father who cried wolf. I couldn’t, or didn’t want to, put myself in his tormented body; and to the extent that I put myself in his mind, I decided that his sickness was exacerbated by his tendency to brood.

Something I didn’t learn until after my father’s suicide is that depression can cause chronic gastrointestinal torment, much as stress can cause back pain, or sadness can cause tears. I doubt that any doctor sufficiently explained that to my father. The mere suggestion that his suffering might have had a “psychosomatic” element made him protest that what was happening to him wasn’t all “in his head.” Of course not. And yet, the brain is as much part of the body as the gut. The brain not only perceives physical pain but can help trigger painful bodily responses, too.

If my father had a better understanding of the mind-body connection, would that have saved him? I can’t say. But while I could imagine his emotional or psychological suffering, I resisted empathizing with him physically. I could put myself into his vision, as he looked down at his dying brother. But I resisted his hurting body. And perhaps because of that — because we think of depression as so much in the mind when it can also be in the flesh and blood and organs — I tried to push him to change his perception. What I should have been pushing for was better medical attention for his body, in all that pain.

Maura Kelly is working on a memoir about her father. She encourages anyone experiencing a mental health crisis to go to an emergency room, call the National Suicide Prevention Lifeline (1-800-273-8255) or visit the National Alliance on Mental Illness site (