I was settling into one of those airport activity tables with high stools and electric outlets at my flight’s gate, waiting for the agent to announce boarding, when I felt a gathering storm at the apex of my butt cheeks. This was my last flight after being away from home on a book tour in May. For the past two weeks, I hadn’t left my chair much, due to all the posting, podcasting, writing, and tense, nervous scrolling that releasing a book involves. But I’d moved just fine from plane to hotel to bookstore. I’d even made a point of walking to the bookstores from hotels and back, to indulge some kind of Walt Whitman–esque fantasy.
But now, at the last moment, alarm bells were going off. The pain felt as if I’d taken a hard hit to my tailbone, as I’d once done after going off a jump in an inner tube and landing ass-first on hard-packed snow. But there was no incident to ascribe the pain to. It had arrived unbidden. And now it not only hurt to sit down as I faced two hours of compulsory sitting, but the pain was growing with every minute.
I spent the flight lurched forward in my seat, weight shifted all the way onto one leg, rocking back and forth as much as I could without looking like I was experiencing a religious hallucination. By the time I had to stand up, it was all I could do to not cry out—as bad as the pain was sitting down, standing up sent a radical guitar solo through my coccyx.
At that time, I was about four months postpartum from delivering my first baby, and had had a blissful recovery, all things considered. I had pelvic muscles of steel, thanks to over a decade of lifting heavy weights, a practice I continued until two weeks before giving birth. I had only been back to lifting for a couple of months—deadlifts, squats, bench, overhead press, here and there some rows or lat pull-downs—but everything had been going well.
At first I thought maybe the pain would disappear as quickly and mysteriously as it came. I knew that, just as the body goes through a loosening and expanding process to get ready for birth, it re-compacts itself slowly over several months after the baby is born. I figured that maybe my sudden sedentariness had healed my body too tight, like in Rookie of the Year. I began doing stretches I found online to try and pull my bones apart again—ankle crossed over knee and knee pulled to chest; sitting upright with legs splayed on the floor at right angles; knees crossed over each other like an overzealous lotus pose. Again, it seemed to help a little, but the pain persisted, and worsened enough to make me cry out every time I tried to sit for more than 10 minutes. This was a problem, because sitting was, in some sense, my livelihood—as a writer, I couldn’t get words down or read unless I could be still. Eventually, after weeks of lying around the house, I made an appointment with a physical therapist, who, after hearing about my problems, forwarded me on to a pelvic floor specialist.
Pelvic floors are not a part of the body that I grew up hearing about. And it wasn’t terribly long before my own pelvic floor episode that I learned we’ve all got one—old people, children, women, men. Most people’s familiarity with pelvic floor activity extends only as far as “Kegels,” a semimystical gripping motion that women are encouraged to practice in order to be good at sex, and more wrongly, to get a baby out of one’s birth canal. But Kegels only capture one small aspect of what the pelvic floor is capable of.
Many, many, many people do not have even this basic ability to intentionally engage their pelvic floor, even people who are otherwise healthy. This often means they don’t have the ability to engage it while picking things up, shifting their weight, laughing, or, for birthing people, when they have to maneuver a baby out of their vaginal canal. These are very core tasks for human bodies, which means pelvic floor issues can lead to a whole host of problems.
But first: a primer. Imagine looking down into your own pelvis as if it were a big bowl with no bottom. The pelvic floor is a set of muscles that span the bottom of that bowl, attaching various parts of the pelvis, as well as the spine and legs, to each other. You may have heard at some point in high school biology that the diaphragm, the muscle that controls our breathing, is relaxed and unengaged when our lungs are empty, and when we draw a breath, we are flexing and engaging it. The trampoline-like pelvic floor is designed to, among other things, move in parallel with the diaphragm: When we inhale, it relaxes as all our organs move downward into it to make room for the breath. When we exhale, it flexes again. There are additional muscles that control our bowel movements, even the ones that help maintain an erection, for men.
But what I just described is a functioning pelvic floor. When we get stressed out, overburdened, fevered in the soul, traumatized, betrayed, bamboozled, run amok, or, say, forced to bear witness to constant atrocities, daily mayhem, senseless violence, and destruction—these problems can manifest as pelvic dysfunction, no matter who you are. As health-adjacent trend chasers have realized that pelvic floor problems represent fresh, untrammeled marketing earth, they have rushed in with purported treatments, products, solutions, and quick fixes. And there is nothing I understand better, now, than the abject need to drink directly from the garden hose of social media infomercials, unable to afford concern that its plastics and heavy metals will rot my brain.
The laconic physical therapist clad in a white coat trained her eyes up the barrel of my nether regions, cueing me to tense my pelvic floor and relax it again. She affirmed it was strong and responsive before indicating she would have to examine me from the other side. She went back in, so to speak, and had me repeat the exercise. “I don’t feel that your tailbone is actually out of position,” she said. “OK,” I said. I imagined that it was possible to feel shortchanged by an exam like this, that if she did not take her time, people might feel dismissed or examined too perfunctorily when it came to entrenched pelvic pain. We sat there as the sun and moon rose and set, glaciers melted and the sea rose, all life turned to dust and mountains crumbled into the ocean and several ice ages came and went until finally I could feel new life being born again in some primordial cradle. Finally, she spoke. “If your tailbone were out of place, I would be able to feel it, but it is in a good position where it is,” she said. I flailed internally with impatience. And then—“Do you hold your breath?” she said.
This caught my attention. For my entire life, I’ve habitually, unconsciously struggled to breathe steadily, for reasons connected to my unbearably tense family life growing up. “Yes,” I said.
“I can feel it,” she said, “you never fully relax your pelvic floor. There is always 20, 30 percent of tension you are still holding, even when you think you are relaxed.” It was the amount of tension that I associate with what I would call “polite fart prevention,” the same way I’d learned to hold my abdomen in an inconspicuous sucked-in position after one high school friend slapped my hanging stomach enough times as she passed me in the hall. The physical therapist told me that I had a seeming panoply of problems that could all be minorly adding up to this one big issue. The rearrangement of my body parts had me still standing in pregnancy stance; I had weak lower abdominals that were still separated, as was the joint at the front of my pelvis, which had caused me intense pain toward the end of my third trimester and would benefit from more core exercise.
“Like dead bugs?’ I said.
“No,” she said, shaking her head, mildly revolted. “No, no. No no no no. Like planks.”
She had me lie on my stomach and prodded at my sacrum at the base of my spine, noting that it was misaligned, tilted outward on the left side but inward on the right—a side effect of playing sports when I was younger, where, as a leftie, I stabilized on my right side and threw or kicked with my left arm or leg. She put the heels of her palms at the top of my left butt cheek and steadily leaned her weight on my hip until I felt a gentle pop.
When I sat up again, in addition to the planks, she told me that I needed to develop the habit of letting go of all of my pelvic floor tension when I was sitting down. While I was frustrated that there didn’t seem to be one easy answer to my pain, I was fascinated that my pelvic floor dysfunction seemed to potentially exist at the intersection point of multiple running timelines: family trauma, recreational sports, pregnancy, a writing career, unrelenting ongoing unforgivable atrocities all around, all of it coming together to yank on my tailbone like an insistent toddler. It had gracefully tolerated one injustice after another, until the straw of a book tour broke its back.
John De Lancey, the director of pelvic floor research at the University of Michigan Medical School, is nattily dressed in a black polo buttoned to the neck, with neatly combed hair. Behind him hangs an illustration of an anatomical cross section: In the 19th century, a pregnant woman’s cadaver was cut in half and the glass was pressed up against the cut side, so an artist could draw it. De Lancey said that this is one of the most accurate anatomical illustrations that exists, but no one other than him had sought it out to actually see it in the last 50 years.
There is hardly a body part that lends itself less to a 2D rendering. In most images of the pelvis, it’s difficult to impossible to tell what cross section you are looking at, whether the spine is pointed down or at your face, whether it’s at the front or the back. Anytime I look at a pelvis picture, I get an overwhelming need to just hold a 3D model that I can turn over in my hands and open up. It’s almost worse the more detailed the images are. It doesn’t help that, according to De Lancey, most of the diagrams of pelvises on the internet are wrong.
In fact, “virtually all the drawings are wrong,” he said, because they all copy one another and replicate the errors. Most of the correct ones, he said, derive from the early 20th century, when artists would draw the pelvic floor from life. Because of its orientation, its placement, and its functionality deep inside the body, De Lancey said, it was the one area that even medical professionals working on living patients would never, could never, see.
Even as the anatomical renderings got more accurate, the pelvic floor and its functions were a straight-up mystery. But it was, at least in part, for lack of trying: When cadavers were studied for pelvic floor anatomy, it wouldn’t be a matter of record whether the living person had ever given birth, De Lancey said. Kristi Kliebert, a board member of the Academy of Pelvic Health, referred to it as a once—“mystical area.” We used to believe that when a person gave birth, everything down there just sort of gave out, like so many pieces of chewing gum. Postpartum people took it as a matter of course that their pelvic area was shot, and they would forever after pee a little when they laughed or otherwise physically exerted themselves.
But the medical world was missing an absolutely massive piece of the well-being puzzle for a lot of people: According to one paper, more than 25 percent of reproductive-age females globally have some form of pelvic floor dysfunction, including chronic pain, pain during sex, incontinence, organ prolapse, and a host of other poorly understood conditions. And as in so much science, especially science that covers a part of the body we are continuously embarrassed by and prefer not to acknowledge, that’s only the cases we know about.
There are three main reasons that, no matter how much we ever know about the pelvic floor, it won’t make good party conversation: sex, pee, and poop. The pelvic floor contains all the doorways for excrement, however they may end up being used, as well as those for reproductive functions, however those may also end up being used.
It wasn’t until the late ’70s that doctors and researchers started to look more closely, and found that the pelvic floor’s thin sheets of muscle could be conditioned, strengthened, even rehabilitated like any of the other muscles in the human body. In 1977, the American Physical Therapy Association established the Academy of Pelvic Health Physical Therapy. According to De Lancey, MRIs plus healthy women volunteers in the 1990s and 2000s changed everything. It was suddenly much more possible to study a pelvic floor they could confirm was currently healthy.
“Healthy” in pelvic-floor terms means, first and foremost, that the person doesn’t unintentionally urinate or defecate, and that none of their pelvic organs are prolapsed (meaning, sagging out of their openings, a fate that can befall them when overly intense strain meets a weak pelvic floor). It also means that the pelvic floor muscles are strong, that they don’t lose tension when challenged; and that they are coordinated, meaning the person can engage them as a unit. Weakness and lack of coordination is what can lead to incontinence, and no one likes to get up there in years and pee themselves while they are trying to move the couch. As the profile of the pelvic floor continued to increase from the 2000s, this was the driving force behind a lot of pelvic floor research. Even still, the shame issue, plus the genderedness of pelvic-floor-related prolapse and incontinence, meant that we tended to accept that women who have given birth may just pee a little when they laugh for the rest of their lives—until the cause was taken up by brands like Goop, who likely saw opportunity for profit.
The innate skill of pelvic floor functionality seems, for now, to be somewhat random. Even elite athletes do not consistently have possession of their pelvic floors. In other words, you’d be shocked to know how many of our finest specimens of the human race are out there on the court, floor, platform, or field, peeing their pants a little as they perform some of their most difficult maneuvers. I am not kidding. Studies of athletes ranging from Olympic trampoline jumpers to triathletes to indoor football players to basketball players find that they are about as likely to experience urinary incontinence, or what is called “stress incontinence”—when a pelvic floor yields to strain and involuntarily releases some pee—as the general population. Sometimes more.
One of the specific things researchers have learned through more pelvic floor study was that the levator ani, the muscle sheets that run from the front of the pelvis and attach at the very tip of our coccyx, or our tailbone, get particularly stressed during childbirth, and can be torn or even ruptured. I seem to recall being told over and over throughout my life that the tailbone was a vestigial body part, one that symbolized our evolution from deep into the mammalian tree. It does not seem so vestigial to me anymore, holding together as it does the very cradle of life.
Over the next few weeks, I became very aware of where my pelvis was sitting in relation to my body. I found myself bent into a strange shape when I walked, upper body cranked forward and hips cranked all the way back. I tried to pull myself into more of a regular human shape. I stopped my stretches and committed to my planks, even though I have always hated planks. I tried to release my held pelvic floor tension when I could remember, which was admittedly not often.
I realized that while I was holding my son to rock him to sleep, I was cranking my lower back forward, turning my spine into a question mark, like sitting up straight but too much, to give him more of an incline to rest on, putting a lot of strain on my pelvic floor. I tried slouching in the other direction. Similarly, the lack of frontal tension meant my butt was skating out from under me in the bottom of my heavy squats. I started making more of an effort to keep it underneath me.
At my next PT session, the physical therapist asked how my pain was. Better, I said, it came on less quickly and hurt less, though going from sitting to standing still gave me a surge of pain. I proudly told her I had been dutifully doing my planks, that I could hold them for a minute at a time.
She made an indifferent expression and shrugged. “Sure,” she said, clicking on her computer. She laid me down on the table and probed my sacrum again, and then pronounced it less stiff, though still misaligned. She pressed on it again gently, hoping for the same pop as before, but none came. She moved her hands up toward my shoulder blades, pressing to the left of my spine. “You are tense,” she said thoughtfully.
“Does it have to do with what’s going on in my sacrum?”
“Maybe,” she said. I had looked up the sacrum between appointments—a big triangular bone at the base of the spine where one side of the pelvis meets the other, where the upper body meets the lower. Sacrum is either from the Latin for “sacred,” or maybe just a mistranslation for “strong bone.” If you’ve heard of the “SI joint,” that is where the sacrum meets the ilium, the pelvic bone on either side. Important nerves pass through this joint, such that if my sacrum problems were to get worse, I could look forward to sciatica and even incontinence.
As I waited for the PT to give me some advice, I noticed that across from a corkboard buried in effusive thank-you notes from past clients, she had a poster of chakras hanging high on the wall above the cot. My pelvic floor was in the sacral chakra, associated with the color orange, the element of water, emotions, desires, relationships, and creativity, and governed by Parvati, the goddess of fidelity, fertility, and power.
The PT suggested I do bench presses, overhead presses. “And this,” she said, extending her arms fully to the side, thumbs pointed to the ceiling, and bringing them together over her head. This was about the last thing I expected to be told to do for my pelvis.
The issue that spans across demographics is the mysterious world of pelvic dysfunction. (The set of pelvic muscles that enable erections, in both penises and clitorises, is called the ischiocavernosus, for those taking notes at home.) In the same way that a tense experience, like someone jumping out from behind a wall and scaring us, triggers certain physical responses—racing heart, shallow breath—acute or chronic traumatic experiences can cause people to unwittingly create and hold tension in their pelvic muscles. When that tension becomes habitual, they may become incapable of fully relaxing their pelvic floor without conscious, and sometimes sustained and dedicated, effort. Ironically, this tension can also lead to symptoms like incontinence and organ prolapse, just like trying to hold a full beer stein out in front of you with every last bit of energy you have may result in you dropping and shattering the stein on the floor.
Now might be a good time to try and detect your own pelvic floor. Sit on the corner of your chair, or more ideally the corner of a table, so that the area between your legs is in full contact with the surface. (If you’re in a public place or office, try to be … a little bit subtle about this.) Now imagine you are trying to lift that area away from the surface by contracting it, and hold it there. Now, relax and try taking a deep breath, and try to breathe all the way down into your abdominal cavity, all the way into where you are making contact with the chair or table, which will create gentle downward pressure. If you can do all that, at will, and hold your contractions and flexions for at least a few seconds, your pelvic floor function is likely pretty good. If you can’t feel anything at all happening, or there is tension and you can’t either release it or create it, you and your pelvic floor might be long overdue for a conversation.
The pelvis and its many ligaments and muscles and tendons are something like the puppet master of the rest of the body: Tension or dysfunction within the pelvis can manifest in symptoms as wide-ranging as dull lower back pain, shoulder tightness, shooting thigh pain, butt pins and needles, and more. This is to say nothing of issues that occur in the pelvis’s many organs—IBS, constipation, painful urination. Inability to relax the pelvic floor can cause problems, too, just as overly loose or unengageable pelvic floor muscles can.
So if athleticism isn’t the key to a functional pelvic floor, what is? For the last couple of decades, researchers have been circling the muscles of the pelvic floor, wondering how it can be helped. They were beginning to understand that pelvic floor function was not a matter of random fate, or even medical history. Pelvic floor functionality was teachable. But how?
Kari Bø, a professor emeritus for the Norwegian School of Sport Sciences, has been researching pelvic floor functionality especially as it relates to incontinence for more than 30 years. The facts are plain to Bø: Everyone can, and should, know how to engage their pelvic floor.
In the 2000s, Bø collaborated with the Swedish company TENA (maker of incontinence pads) to record a training video for exactly this purpose. They even stylized the video so it would blend in with at-home workout DVDs of the day, with the exercises led by Bø flanked by two backup instructors, all clad in aerobics gear. The DVD was sent for free to half a million women and, eventually, ended up online. When asked about the kinds of pelvic-floor training videos one might find on social media, Bø laughed. She cited so-called “experts” that prescribe exercises like glute bridges. “That has nothing to do with pelvic floor muscles,” she said. (She and De Lancey both scoffed mightily at the idea of Kegels, characterizing them as a borderline useless concept that has been repeated mindlessly by people who don’t know what they are talking about.)
Bø’s method is called “pelvic floor muscle training,” or PFMT. The full complement of exercises, including a general warm-up, runs about 24 minutes. As Bø sweeps her body gently through one movement after another, I can sense the frustration that comes with dealing with a body part we cannot really see, that someone can’t effectively show another person what they mean by tensing or relaxing a set of muscles without giving them the most graphic possible view of our bodies. As the video runs, Bø instructs the viewer to lift up the pelvic floor, using her hands in front of her pelvis to mime the motion that should take place. But clothed and upright as she is, the viewer cannot really view what she is doing during a lot of the exercises. I sought out another video from the UK National Health Service which featured, finally, a 3D rendering of pelvic floor muscle exercises—which, at long last, showed the whole thing in action.
That all said, it’s difficult to teach any body movements, no matter how much “showing” another person can do. It’s one thing to mimic the motion of, say, a dead lift and another to use all the right muscles to do it. Going from motion-mimicking to true bodily engagement takes some deliberate practice and internal attunement to how one’s body is moving. Sometimes, just pointing our attention to the right place within ourselves can build connection and function, and provide relief. But as the 24-minute length of the video reflects, this takes time and patience. If we’d had time and patience afforded us in the first place, we might not have pelvic dysfunction at all.
At my third PT session, I reported that I was feeling much less passive pain, though still sharp twinges when I stood up from sitting. Now instead of it feeling as if it was squarely in my tailbone, it had shifted to the left, deep in my butt cheek. I was also feeling some kind of tendon plucking against a bone in there whenever I took a step with my right foot. I’d spent some time before my appointment rocking my hips back and forth while resting a hand on one cheek, playing Marco Polo with the pop, only to find I couldn’t feel it from the outside. I felt like I was chasing a mischievous ghost haunting my pelvis, always opening and shutting cabinets and doors and giggling from down the hall. Here I was, living proof that even with the full faculties of one’s pelvic floor, it was possible to be undone by old habits and entrenched reflexes. Despite this, the physical therapist seemed to be zeroing in more on the problem every time.
The physical therapist pulled up a diagram of the many tendons, ligaments, and muscles that densely crisscross the pelvis. It looked like one of those obstacle-course set pieces that is a forest of bungee cords. I pointed to one that seemed like it was in the right spot: the iliococcygeus, a muscle that runs from the tailbone to a set of connective tissues toward the front, and just under a spiny edge of my sacrum, which, if shifted out of place, could feasibly be plucking on my ilicoccygeus deep inside my hip. But how to access this incredibly specific muscle we could not even see or probe, much less move intentionally?
The physical therapist thought a minute, chin in hand, gazing at her computer screen, before she had me lie down on the cot again and hold my left leg up, bent at a right angle, and then gently, almost imperceptibly, lift my right buttock off the cot. I could barely hold this position for a count of five. I released, and then about two seconds later she said “again,” seven more times. She pointed me outside to walk down the hallway. The popping was gone. Who was this witch?
“Twice a day, eight reps,” she said, turning back to her computer.
The thing about pelvic floor functionality is, you can have the most beautiful, responsive, strong pelvic floor in the world, and no amount of pelvic brains or brawn will prevent it from getting a little bent out of shape in the process of giving birth. In every birth, De Lancey noted, the connection between the left and right perineal membrane ruptures a bit. De Lancey, a master of mechanical analogies in the way a rarefied few science teachers are, likened this to a button popping on a too-small vest against a large stomach. Structurally, everything still works, but the abdomen sits a little different than before.
De Lancey was careful to note that only about 20 percent of women have impactful and lasting pelvic floor damage. And some of them won’t see those issues come to bear for a very long time; for instance, a muscle tear during labor may mean that, 20 years later, that person is susceptible to organ prolapse or incontinence. But when it comes to preventing or mitigating those issues, half a well-functioning pelvic floor is better than a whole pelvic floor that can’t be controlled.
A very large contingent of pelvic floor rehab is focused on helping people post-delivery. In European countries where the health care system treats women like human beings—France, for instance—women receive pelvic floor physical therapy as a matter of course after having a baby. But De Lancey noted it’s likely that we may be overtreating problems that resolve on their own, or do not benefit from treatment, all while we are still trying to nail down appropriate treatments for problems we actually do have.
A systematic review just published this summer made a wide-ranging analysis of virtually all accepted treatments for pelvic floor dysfunction. An inexhaustive list: physiotherapy at home and in-office; antidepressants; electrical stimulation; shockwave therapy; dietary modifications; sexology advice; hormone therapy; NSAIDs; mindfulness-based therapy; intravaginal valium; respiratory and pelvic floor muscle coordination; heat; muscle relaxing postures. The main finding was that multiple treatment types tended to be more effective than any single treatment. To a normal like myself, this feels not unlike reading a list of possible medieval medical treatments for a now-mundane condition like scurvy, before we figured out it just means you need vitamin C: drowning a cat in a river that flows north, drinking a tincture of wolfsbane under a full moon, visiting the local leper, hitting oneself with sage bows, something to do with the four humors. It also feels very likely that, eventually, we will develop a more nuanced and detailed understanding of various pelvic floor conditions, which will sharpen our treatment approaches. For now, we are throwing in the kitchen sink. And it works—if, again, time and patience to complete multiple treatments are in supply.
In the United States, we use a biomedical approach, where medical systems identify medical problems that get medical solutions like drugs and surgery. But these are two treatments that have proven uniquely ineffective for most kinds of chronic pain. Pain relief drugs are generally either not powerful enough to relieve pain reliably, or not safe enough to take in significant doses over a long period of time. Surgery requires a physical defect to correct, which is often not present in chronic pain. Even in the event that it is in the case of pelvic floors, as with rupture, De Lancey noted that surgeries have not been successful.
In more developed countries—Canada, Australia, a lot of Europe—medical care for chronic pain, pelvic pain included, is moving toward a cross-disciplinary “biopsychosocial” approach, which helps pare down the sea of treatment options by assessing family circumstances, mental health, and social relationships in order to evaluate how appropriate treatments like exercise (the number one effective treatment in pelvic pain and many types of chronic body pain), massage, mindfulness techniques, or psychological treatment may be, in order to not medicalize a problem that may have a nonmedical solution.
Another way of putting this might be that lifestyle problems require lifestyle solutions. In America, our medical model is based almost entirely around acute problems and acute solutions—instead of a health care system and culture that provide for time and energy to go outside and exercise, or to eat a well-rounded diet, in order to prevent heart attacks, we just wait for the heart attack to happen, and then receive emergency quadruple-bypass surgery, for which the hospital bills our health insurance hundreds of thousands of dollars. We are encouraged to ignore our lifestyle problems until they slap us in the face. But this approach is proving more and more worthless when it comes to issues like chronic pain and body dysfunction, which cannot be disappeared with a pill or a surgical procedure. It also ignores the enormity of distress that accumulates when it’s not a medical emergency, but wakes up alongside you every single day.
Helena Frawley, a professor at the University of Melbourne and a coauthor of the systematic review, said that the future of pelvic pain treatment will be person-centered, similar to the one we take for other complex conditions, like cancer. Rather than throwing the book at a cancer case, doctors now avoid (or are ethically supposed to avoid) prescribing complex courses of aggressive radiation and chemo to a person who wants to preserve their quality of life, and may only live a few extra months even with the most involved treatments. Similarly, in our theoretically glorious pelvic-pain treatment future, doctors will (or should) listen carefully to the patient about their needs and capacity to execute various treatments, and prescribe accordingly. In other words, the more we listen to and try to understand each other, the better things will get. We just have to then, you know, do the hard part.
My physical therapy treatments continued to improve things. The one-foot-up exercise reliably popped my hip and stopped the plucking feeling inside, but I would still feel twinges of pain standing from sitting. In an act of exercise desperation, I signed up for a shift working construction for Habitat for Humanity.
I got a ride from the meeting spot to the construction site with a young man in his twenties who planned to become a doctor, and who told me he eats the same food for lunch and dinner every day (beef and sweet potatoes) because it is the perfect meal, and also he has one-fifth the tastebuds of a normal person. (When he later opened his lunch: beef and sweet potatoes.) Our group of 10-ish people set about painting and nailing trim to a shed in the backyard. The sun was mirror-bright and hot, and I splattered paint all over my clothes, shoes, and hat. Sweat soaked my hair. The foreman let us take turns practicing with the palm nailer and the miter saw. We worked for five hours.
Later that day, as I sat on a curb waiting for my husband to pick me up, I noticed that, despite the fact that I was sitting down on a hard surface, my backside was not hurting for the first time in months. Was it the exercise, the bending up and down to sweep the paint roller? The heat? The biopsychosociality of working together on a project with a bunch of other people I didn’t know? The mindfulness of having my brain fully occupied only by thoughts of construction? The specious dietary modeling from the aspiring doctor? Maybe all. Maybe some. Maybe none. Maybe something else entirely.
After that, I started volunteering to garden in a nearby park. Eventually, the pain became duller and more occasional, better than it’s ever been. I had developed a tendency to sit stiffly to prevent the worst of the pain that I didn’t have anymore, a new set of reflexes that I now had to unlearn. I cannot be sure now if the pain will ever fully go away, if doctors and researchers will manage, will bother, even, to fully chart the constellations of pelvic problems the human body is capable of in my lifetime. This makes me desperately angry if I think too much about it. The uneasy and uncertain journey of pursuing a solution that may never come spools out before me. But perhaps the true task is learning instead—metaphorically, if nothing else—to sit down where I am.
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