Thank you, everyone, for your patience as I moved my entire life 500 miles. There is still work to be done, namely, starting my new position today, amongst other things. BUT, I’m ready to get back to blogging! Hooray! I’ve missed ya’ll! So we’ll start off with April’s Journal Club article….
I had seen this article pop up in the January issue of PTJ and had been wanting to read it, but never found the time. So I made it a Journal Club article, forcing my own self to make time to read it. This article calls on your narrative reasoning skills (the appreciation of patients’ stories in order to gain insight into their experiences of disability or pain) to learn a bit about chronic pain as a disease process. (Before we go too much further, we will be discussing and looking at Frida Kahlo’s art in this bit, some of which may not be appropriate for young eyes.)
Magdalena Carmen Frieda Kahlo y Calderon aka Frida Kahlo was a Mexican artist and feminist born in Mexico City in 1907. The Mexican Revolution of 1910 turned the culture’s focus from European glory to the beauty that was Mexican culture. This insighted a deep nationalism, and encouraged creativity and free-thought– an artist’s paradise. However, her life and her artistic works were effected by a series of tragedies in her own life.
First, as a small child of 6, she contracted polio, which effected her right leg. She was bed ridden for 9 months at this time and still had the typical presentation of polio in that right leg– muscle wasting and weakness. Her medical records also state that the leg did not develop normally, making the leg shorter than the other (structural leg length discrepancy) and an accompanying twisted back (functional scoliosis). Then, as a pre-teen, she experienced several instances of sexual abuse allegedly at the hands of a school teacher and her own father. Then at 17 years old, she was involved in a horrific street car accident which left her with multiple injuries including: multiple broken bones (clavicle, ribs, spine, elbow, pelvis, leg and right foot); both ankles and shoulders were dislocated; an iron railing pierced her at left hip and exited through the pelvic floor. In an era before antibiotics, it’s a miracle she survived this. In her later years, she struggled with her relationship with Diego Rivera, her husband, who tended to take many lovers. This caused severe depression. She also had bouts of anxiety centered around birthing children due to her own history of physical, sexual and emotional trauma.
As Frida ages, all the above combine into an ever intensifying battle with chronic pain. The article speculates that it may have been a combination of trauma from the accident and post-polio syndrome that caused her neuropathic pain and vascular insuffiency in the right leg. Some experts are thinking she may have transitioned into complex regional pain syndrome type I or II. In 1934, the toes of the right leg were amputated and in 1953, she had a below the knee amputation due to gangrene. She also had severe, ever increasing back pain as well, due to the accident trauma and scoliosis. She underwent several back surgeries, including a failed fusion. None of which alleviated the pain. How many times have you heard that story from your chronic back pain patients? Frida also had psychologic pain superimposed on the physical trauma her body underwent. In summary, Frida Kahlo was a ball of pain, all the time.
Because she was in pain all the time, pain was at the forefront of her mind and many of her paintings, as seen below.
In her paintings, pain is represented by arrows, nails, blood, fire and occasionally tears. But no matter what she is feeling, her face is always stoic. Pain then, as well as today unfortunantely, was seen as weakness. A woman of her time, and position could not afford to show any weakness outwardly. What modern person can either? This is life for a person with chronic pain.
Frida Kahlo passed away in 1954 at the untimely age of 47. The diagnosis was a clot in the lungs (pulmonary embolism), but some speculate suicide. “Yet, it is how she chose to live her life, not her death for which she is remembered. Her strength of character led her to manage her condition and live her life with purpose and dignity. Her paintings provide a unique and personal view of chronic pain, which was clearly a catalyst for her brilliant catalog of work.”
If you enjoyed this piece, I highly recommend checking out the 2004 film Frida starring Salma Hayek as Frida Kahlo in a biographical sketch of the artist. It is entertaining as a movie, and instructive in the life of Frida.