Katie Paine
“The Invisible Geographies of Pain”

1. Can you describe your pain on a scale from 1-10, with 10 being the worst you can imagine?

1. On this diagram of the body, please circle the places where you experience pain.

1. And how would you describe this pain? Is it: burning, shooting, muscular, throbbing, dull, aching?

Part One.

The Merriam-Webster Dictionary contains approximately 470,000 words from the English language, and it is estimated that there are similar multitudes within all the languages across the globe.1

We have 13 words that can be used in place of the word ‘door’, another 14 for the word ‘sky’ and at least 8 to describe the coming of old age.2 As a society, we pride ourselves on possessing a language that can encompass the world around us, so we may accurately articulate our experiences to others.

Surprisingly, however, to speak of the experience of pain- the ever-changing sensations, the magnitude - especially within the midst of pain, remains difficult. American Professor of Literature, Elaine Scarry, wrote in depth about the complexity of articulating pain, and its potential for mistranslation in her 1987 book The Body in Pain: The Making and Unmaking of the World.

Scarry poses in the book’s introduction that “when one hears about another person's physical pain, the events happening within the interior of that person's body may seem to have the remote character of some deep subterranean fact, belonging to an invisible geography that, however portentous, has no reality because it has not yet manifested itself on the visible surface of the earth.”3

Visibility. As a species, we repeatedly ask for evidence for occurrences: photographs of accidents, official documents to corroborate a birth, the testimony of others when no tangible evidence can be found. When conceptualising the experience of others, we are often subconsciously prone to doubts and disbelief. Scarry asserts that it is “easy to remain wholly unaware of its [pain’s] existence; even with effort, one may remain in doubt about its existence or may retain the astonishing freedom of denying its existence…pain comes unsharably into our midst as at once that which cannot be denied and that which cannot be confirmed.”4

Scarry discusses the complexities of sharing pain with others through its resistance to language. She refers to Virginia Woolf’s 1926 essay On Being III in which she writes: “English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver or the headache. The merest schoolgirl when she falls in love has Shakespeare or Keats to speak her mind for her, but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry."5

To speak to a doctor of a persistent headache is one thing, but to utter speech during the agony of childbirth, the catastrophic pain of blunt trauma, the smog of a post-surgical haze, is to be robbed of speech. What is uttered instead is a cacophony of guttural yells, shrieks, moans, or a soft and strangled gasp.

Scarry goes on to articulate that “because the person in pain is ordinarily so bereft of the resources of speech, it is not surprising that the language for pain should sometimes be brought into being by those who are not themselves in pain but who speak on behalf of those who are.”6

Doctors, nurses and other medical professionals are often those we look to beseechingly to empathise with our pain, and yet, in these discussions we are first and foremost asking them to trust the articulation of our innermost experiences.

Trust becomes the crucial term here, a fickle and elusive phenomenon. Scarry reminds us that doctors “in effect, perceive the voice of the patient to be that of the unreliable narrator of bodily events”7

Part Two.

Trust is considered a beautiful and generous human quality, and yet recent global events would assert that, as a society, we are utterly reticent to trust. Locally, in 2011, the Australian Government Productivity Commission recommended a national disability insurance scheme (NDIS). Established in 2013, the NDIS became “one of the largest policy reforms in Australian history.”8 Instead of funding organisations and institutions, the scheme was intended to distribute funds to those individuals who accessed the scheme, with options to fund access to support workers, accessible transport, care in the home and much more, tailored to each person’s individual circumstances.9

As so often happens when a government initiative gives agency to individuals, stories of ‘dole bludgers’, of fabricated illness and hypochondriacs intent on wroughting the system began to circulate. So much so that an independent regulatory body was set up to ‘catch out’ such ‘perpetrators’. And yet at the same time, many lives have been radically liberated and altered by the support structures this scheme facilitated.

In 2024, legislation known as “Getting the NDIS Back on Track" was passed; the government described this as “slowing the growth of NDIS spending”. This involved “patients having less discretion over how funding can be spent” and participant access to a range of supports could be limited.10 Whilst my reference to this complex set of policy changes may be brief and selective, the impacts of this legislation are multifaceted, ongoing and catastrophic. As headline after headline leaks across the media, it continues to remind me how the bureaucratic chorus of the institution demands evidence of illness, trust is eroded and care becomes algorithmic or a series of check boxes.

Part Three.

In April 2015, I had a total hip replacement, the seventh in a series of surgeries with which doctors attempted to stabilise a joint that had lost blood supply and was gradually disintegrating. The surgery was to comprise manoeuvring through ropes and knots of previous scar tissue and would culminate in a lengthy recovery process. I knew this before going into theatre. I knew from all my other surgeries that the promise of total ‘recovery’ or surgical “success” was never a given. I went into this surgery with a deep feeling of foreboding, and yet I was wholly unprepared for its aftermath.

It took many days for my anaesthesia and a medley of heavy opioids to wear off. As my mind drifted back to my body, so did the heavy, throbbing ache of surgical pain. This time, however, it mingled with something else. An electric, mercurial pain that struck with a frenzy I had never experienced before. Violent, searing and all-encompassing. Before I had fully gained awareness of the surgery’s aftermath, my mother, my father, doctors and nurses urged me on the hour to wiggle my toes, to shift my knees. Why do they keep asking me this? I wondered sleepily. Initially they hypothesised that the epidural had left complications. I was discharged unable to move my leg from the knee downwards. After weeks living under the doctrine of ravaging pain, I learned that my sciatic nerve had been damaged and that my leg was partially paralysed. Neuropathic pain involves damaged or malfunctioning nerves that send pain signals even when no new injury occurs. Two years of my life, during which pain erupted again and again and again.

I remember when my mother was dying of cancer, the nurses told us she would be in a ‘significant amount’ of pain. From the outside, she looked gaunt, frail and a little jaundiced, but there was nothing that told directly of this pain the nurses spoke of. I often found myself looking at her and wondering how this pain came to be. Was it in her bones, her organs, or did her tumours emit some kind of secret malevolent pain signal of their own? I found these thoughts nauseating and impossible to bear. It is far easier to think of pain as some kind of gory and blatantly obvious ‘event’ like that of a physical blow or the cut of the serrated edge of a knife. I could not cope with the idea of pain as this insidious ghostly thing I could only picture in my mind's eye.

Part Four.

These memories started coming back to me as I began writing this response to an exhibition by artist Kari McInney-McRae, Not an Angel, Exactly. McInney-McRae’s practice encompasses many aspects. When we first met over 10 years ago, they were making playful and curious ceramic vessels installed in complex formations. Their practice has since evolved to incorporate sculpture, video, performance, photography and drawing. Visiting many of their exhibitions, I have often found McInney-McRae’s work to consider the temporality of the body; whether it be the complex ways memory is cocooned within muscle and movement, the languorous time associated with swimming and, in recent years, the body in pain. Kari’s work considers the private and complex temporal mechanisms of the body; protracted periods of endless waiting and the temporal shock that comes with a feeling of having lost time. Kari has often used poetic, reflexive writing and drawing as a way of tracing the somatic patterns of the body, as methods of timekeeping when there is little else to hold the world steady

This text has been written to consider their work My Clunky Bits, an Archive and Acacia paradoxa excisions, exhibited in West Space’s “window” vitrine. At West Space, the aperture of the window has been doubled. As visitors, we peer through glass, and then through what could be a frame of sorts made up of starched blue curtains. These pale ‘curtains’ are neatly arranged clinical dressings, the kind that demarcate the place of intended surgery and protect surrounding skin from the leakage of bodily fluids. From under their folds, a square expanse of mottled skin looks out at us. Beneath the navel lie two thorny twigs cast in bronze, arranged tenderly as if they are some kind of mysterious ritual offering. I have had the opportunity to hold some of these bronze twigs of which McInney-McRae has made many iterations. They have a fine, jewellery-like delicacy to them, surprisingly fragile things I might be able to bend or crush between my fingers and palm, yet to do so would leave deep tears from their piercing thorns.

My Clunky Bits, an Archive leaves me suspended in a single moment of time, a moment of overwhelming dread. It seems we witness the fearful seconds before a scalpel plunges beneath dermal tissue, slicing through fat and sorting its way through a mass of organs. The seconds before pain leaves little else left.

My Clunky Bits, an Archive also suggests a corresponding mirror image, conjuring an imagined scene from an opposite perspective. We inhabit the body of the photographic subject. We lie prone on a narrow metal theatre table, our hands swathed in layers of plastic, anaesthetic cream, cannulae. A descending gas mask emanates the noxious, sickly sweet scent of anaesthesia. An anonymous masked practitioner looks down at us, asks us to “count backwards from 10.”

At the same time, we also adopt the surgeon's gaze. McInney-McRae’s work asks us to inhabit an uncomfortable position. It may as well be us who inflict the first cut. We are the ones with authority, able to reach down and pierce the plane of the stomach. We inhabit the fear and anguish of the patient but, at the same time, the agency of the surgeon capable of administering treatment as well as agony. When I look at Not an Angel, Exactly, I feel complicit - a patient’s trust is placed in us as onlookers; we are asked to accept an utterance of pain, to believe in its presence despite being given no corresponding evidence.

Perhaps this is what McInney-McRae's work asks of us: not that we try to comprehend the immensity of pain, but that we linger beside the tenuous space of what cannot be fully known. Some geographies must remain invisible, even as they shape the world around them.