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Poetry and Medicine
May 17, 2006

Tic Douloureux—

Author Affiliations
 

Poetry and Medicine Section Editor: Charlene Breedlove, Associate Editor. Poems may be submitted to jamapoems@jama-archives.org.

JAMA. 2006;295(19):2224. doi:10.1001/jama.295.19.2224

The distances between the molten seas
of nerve? Leagues of a pain where
words won't satisfy patience—not
sclerotic, not merely inflamed.
How do we know? We're thrown in. We swim.
Cold springs of the trigeminal nerve
meet the semilunar ganglion
between tiers of the dura mater
in a deep depression on the floor
of the middle crania fossa called
Meckel's cave, a meeting we can know
only alone. There we slap, twist,
writhe the hook and leader—metal held
fast in bone—and then we sound the depths,
ophthalmic, maxillary rivers, banks
of cavernus sinus, foramen
rotundum, pterygopalatine fossa,
inferior orbital fissure (face, cheek,
the upper teeth), pterygopalatine canal
(palate, nasal cavity, pharynx).
Beyond throb. Tooth-root, tongue.
Waves lave, rearrange the face—tic,
tic—on one side—though doubled.
Trigeminal neuralgia. Worst hurt
known to humans. If only we could ask
the others. We know now that fish feel pain.
On a scale of 1 to 10, how does
it hurt, little brook trout, sea bass,
barb caught behind your bright eye?
We open up our mouths and are jerked
from a blue world into light
that seizes, aches, that takes the breath away.

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