Slipped Disk – New Nonfiction by Paul W. B. Marsden

Joint Winner of The Letter Review Prize for Nonfiction

A slipped disc, that’s what most people call it. Sounds harmless, like a pulled muscle or a headache. Doctors refer to it as a herniated disc or a prolapsed disc. It still doesn’t sound serious or painful. It’s not like a ‘broken leg’ or a ‘defective heart valve’ or even a ‘torn muscle’. The words slipped, herniated and prolapsed don’t sound like there’s any pain involved, whereas broken, defective and torn sound like something is really wrong. In the human body, something being wrong always involves pain at some stage. Physical or mental pain or both.

A slipped disc means that one of those spongy pieces of tissue between the bony vertebrae has moved and is compressing the nerves. Nerve compression is not a good thing. Those are the human sensory wires running around the body 24/7 on alert. They don’t send a fax up to the brain saying ‘Oh, noticed a splintered bone with leg at right angles’. No, in a fraction of second, they send a live round into the mind, screaming ‘Incoming’ and boom. 

Doctors can describe the brain, spinal cord and how the nerves are composed of neurons, dendrites, axons and electrical pulses. Some nerves are as thick as an index finger. That’s a lot of nerve when you think about it. Doctors can go into microscopic details of neurotransmitters and the chemicals that get exchanged and the flow of electrical signals up to the brain. Then you get to pain. Doctors can tell you there’s different types of pain: tissue damage, nerve damage and inflammation. To you the patient, it’s all just pain. From the area that hurts the pain receptors flash a signal to the brain. Then they get stuck. All very well that the pain knows there’s damage or dysfunction or inflammation but what does ‘hurt’ feel like? That’s where doctors do their impressions of fish, gurneying with ah’s and oo’s. Why does one patient rate their pain as 10 out of 10 and another patient with the same condition rate it a 5? Doctors can’t tell you. They say things like, well it’s biology, or it’s psychological or it’s just individual. In other words, they don’t know.

Then there’s the question of what pain feels like. Doctors will innocuously ask, is it a pulsating pain or a burning pain or a sharp pain? All words to give clues and ideas to the patient who can only say, it hurts, it really hurts. But usually, there is zero empathy from doctors. They know what pain is because they are human and have experienced it, but because they are human, they can’t remember pain. The brain has evolved to safeguard its wellbeing by deleting the file marked ‘pain 1997’ because otherwise, it would be able to recall every ache and pain since that person was born. That amount of collective pain would drive a person insane. No, we can’t remember, and neither can doctors. They are also unlikely to have suffered your kind of pain. In fact, even if they had a broken arm the pain would be unique to them and would not be the same pain as if a patient had broken their arm. 

So, what are we left with? Doctors and scientists can describe every little bit of the biology of how and why pain works. But they cannot explain what it feels like for you. Only you know and trying to describe pain is devilish. It’s like trying to describe water. It’s transparent so how can you see it? It’s tasteless so how can you taste it? Pain is something every human knows when they feel it but trying to describe it is devilishly hard.

When I was a teenager playing rugby, a huge lad picked up a teammate with the ball and swung him around at some speed. His booted feet struck my face, smashing my nose. There was a strange sensation of being hit and falling to the ground. Then I saw blood on my shirt and tasting it running into my mouth. The pain only came when I was stood in the hospital an hour later and a doctor started prodding my nose. Then I screamed in pain. It was a sharp, excruciating pain. 

When I was thirty-six, I was training to enter the London marathon. I wanted to beat my best time of three hours seventeen minutes, so I was working out each day. One day I was doing press ups in the lounge and felt a strange pop (there was an actual pop sound). I stopped and had pain wrapped around my right shoulder, burrowing deep inside. After x-rays the doctor found a benign bone cyst at the top of the humerus bone the size of a golf ball. I had three operations under anaesthetic and left me with an endless dull ache with occasional shooting pains deep inside the shoulder and up my neck. Doctors gave up trying to figure it out. The only treatment was painkillers – opioids for the rest of my life.

I suffered a concussion from a seizure whilst driving a car on a weekly five-hour journey to work. Unfortunately, I was driving at 70 miles per hour at the time and I had passed out as the car hit the central reservation barrier with the car ending up on the hard shoulder a quarter of mile away. I stirred and at first felt the shock of what had happened and only (again) in hospital started to feel these overwhelming, head in hands, howling pain of migraines that went on for three weeks.

I took every precaution in lockdown and between lockdowns of face masks, fastidious washing of the mail and groceries and using hand sanitiser whenever my fingers came into contact with anything foreign outside the home. Then two days after I stopped wearing a mask and went to the supermarket, I was struck with Covid. For a week, it felt like knives going down my throat and my mind being gently cooked. 

Perhaps using the metaphor of colour can help describe it?

Colour of Pain 
Blood rabbit runs down leg, burrowing beneath sole.
Sky bite bruises back, howling arch into roll.
Berry juice drilling loose ankle, hip, knee, live trine,
Tangle bramble on running tracks, entwining spine.
Angry sunset melts pelvis into puréed molten marrow.
Captured straiten’d mind, carted away in Satan’s barrow.
Black out brain, jarring jolts lashed by loud lights.
Gasping pig shouts, gnawing spirit of life’s fights.
Roadkill tears stalk chalk face frozen still in space.
Suspicious meadow of respite. Get set, sly pain race.

So, back to the slipped disc or rather the spinal nerve compression. This is like nothing I have felt before. Bear the following single fact in mind. The slightest feathered touch on a nerve causes the brain to morph into a bulging cacophony of no escape electrical fire inside your head. Such pain overwhelms everything else. There is no tomorrow. There is no tv. There are no green hills, nor trees nor sunshine. The love of a partner can’t be grasped or understood. There is nothing in this world except, pain, pain, pain when a nerve is stroked.

Starting seven months ago, the first pain happened when I felt my back explode as I bent to wash the car. It made me feel nauseous and I staggered into the house. Every movement of legs, hips, feet, trying to turn or twist brought on back spasms that instantly contracted muscle groups in my back, sending trolley loads of electrical signals up the spinal cord, plunging into the heart of the brain. That lasted two weeks and then settled into the ugly pain. I’d wake up pain free and for a few minutes wonder if it had gone. Then it would start to ripple like your hand slowly sinking into an electrical socket, only this was in the lumbar region and into the pelvis.

Then an army of ants heated in Hell started to run down my leg. The pains would gently hum at a lower wattage all day so that the only relief was lying horizontal on the sofa or in bed. This wasn’t one pain. It burnt, it shot, it pulsated, it stretched the ability of the mind to comprehend this thing called pain. The ugly pain wasn’t screaming and shouting but it did make me wince and gnash my teeth several times a minute as I moved to make a cup of coffee. Standing for more than a few minutes quickly ratcheted up the wattage until it was searing hot down the legs and burnt the sole of my feet, forcing me back to the refuge of the sofa.

I then had a first disc decompression operation two months after the initial spasm episode. For the first week after the operation, it felt much better. The low hum was gone but then I became a little too cocky and started walking around the garden and picking up empty plant pots. Bang. It felt bad. The low hum was back. I had rounds of spinal injections trying to switch off the pain even temporarily, then one day I felt another sickening movement. It felt like my back was broken and my legs would just fall off my body. The pain was turned up again. Again, more spinal injections but they made no difference. 

At the point of physiotherapy and my consultant doing scans to decide on next steps, one morning I woke up and I had lost sensation in most of my left leg and foot, yet at the same time I had 10 out of 10 screaming, howling megawatt pain scorching down the outside of my left leg and the deep burning on the under-sole of my left foot. They were no longer ants, but wolves trained to tear my flesh over and over. It was terrorist torture. How could I be numb and in pain at the same time?

This episode went on for a week and settled into a routine of me lying flat together with higher doses of painkillers until I could cope with it. However, as soon as I started to walk around the megawatt pain, the wolf pain and the ugly pain all came back – at once. I would whimper and cry and beg for it to stop. My wife was in tears seeing me. She couldn’t bear the arched back and the skin soaked in sweat from trying to exist whilst my brain was kidnapped by pain. When I saw my consultant and described the wolves tearing down my left leg and showing him my foot and giving it a thwack with my fist and feeling nothing, he nodded and told me to put my sock back on. He knows why. He knows how. He just doesn’t feel it.

Then I had a spinal fusion operation to rip out the Goddamn, useless, dumb disc and bolt together the two vertebrae using a titanium cage and screws. I now have a bionic back. The surgeon has told me to expect a forever stiffness due to two vertebrae stuck together, but what the hell. I can expect airport scanners to trigger alarms and a SWOT team to abseil from the ceiling and for me to point to my back and explain that I have a titanium cage. I’ll be smiling, which will make security suspicious. I won’t care as long as there is no pain. If there is pain, I’ll resort to the minefield of the Internet.

I will try once again all the techniques offered by the Internet to control chronic pain. Adding hot or cold to the region would be good for anything muscular as it encourages blood flow but for vertebrae which are bone then it may superficially help but won’t suddenly cure the throbbing, burning or displaced pain running through hips or down legs. Getting the body moving seems to be the best advice, providing the source of the pain has been dealt with. No use going for a run if there is a bit of disc down the spinal canal. 

The suggested breathing exercises have the attraction you can continue to lie on the sofa, although they do bring relatives and friends rushing into the room as it sounds like you’ve gone into labour. There is the British Pain Society giving a quarterly journal and regular newsletter, which you would think be a good organisation to join. But then you find that membership fees start at £100 and go up to £300 per year depending upon income. Really? That’s an awful lot of box sets and movies you could pay for to distract yourself from pain. 

Every single pain management group recommends getting help from your GP. That line must have been written back in 1955 when GPs made house calls but in the 21st century, you can join the 8:00am frenzy and telephone a GP and a) get immediately cut off because the telephone system can’t cope with the number of callers, b) manage to join the queue, only to find that after listening to some version of elevator music for twenty minutes then get cut off, and c) make it all the way through to the call being answered and a receptionist listens to your medical problem, takes your number and says a GP will call you back at say 11am. You then wait by the phone and think I’ll just go to the toilet before they ring only, they ring at 10:45 and you miss the call or you wait and 11:00 comes and goes, then 11:15, then 11:30 and finally you go to make a cup of coffee and miss the call. The upshot is ‘talking to you GP’ is like saying ‘apply to be a gymnast at the next Olympics’. Sure, you can try but it isn’t going to happen.

If it is legacy pain or phantom pain that is caused by that old feeling from before an operation, there is a chance it can be stopped. The body contracts muscles ready for the expected damage to the body even though it has been repaired. The brain gets hardwired into thinking ‘incoming pain’ so does all the things it has been taught to do by experience even though there isn’t a mechanical problem anymore. The brain has its tin hat on in the trenches after seven months waiting for the next shell to explode and thinks it has arrived even though there has been an armistice. The slightest noise of a rat knocking over a tin can or you tripping over and catching yourself in time means the brain lurches into DEFCON 4 when actually you can’t physically hurt yourself any longer from that awkward trip. The brain has to be re taught that the body is better, and it is the dear old mind that now needs to be fixed.

But all that is easier said than done. It takes a lot of will power to make the time to do exercises. All the while the mind is going, ‘No thanks, I’m just fine lying on this sofa, rather than haul myself up, totter forwards, stagger up the stairs and lie on the bed to do a set of teeth clenching movements four times a day. Thanks, but ossifying on the sofa watching reruns of The West Wing is much more appealing’. The Internet even condones this behaviour by including ‘distracting yourself from pain’ in its recommendations. 

Sure enough my fears come true, two weeks after I had my second operation, I experienced a dull ache in my right hip on a Friday. By the Sunday, the pain was through my lumbar region, into my throbbing right hip and shooting into my thigh and knee. If I lay still the pain was bearable. As soon as I got up to the bathroom, I could hardly walk for the pain controlled my body and my mind. When I got back to bed, it took between one and half hours and two hours for the back spasms to cease. These came in waves twisting my spine, screwing up my femoral artery, hammering my thigh and drilling my knee. The spasms went on and on. I arched my back. I rolled my back. I screamed. I moaned. I begged for it to stop. On and on they went. I chewed the duvet cover. I practised birthing routines of breathing. On and on. 

I gave in and called 999 at eight o’clock in the morning. The ambulance crew arrived at ten o’clock, so I was pleasantly surprised. The two men stood in our bedroom and were very friendly and studious, but it turned out they weren’t full paramedics. They weren’t permitted to give pain relief. They called for backup. Then they spent one hour asking questions and filling in forms on an iPad. I asked if the hospital would get all this medical history. They assured me it would and seemed quite proud to say that it was a seamless technological process. All my notes would be ready on the hospital’s systems. I didn’t believe them but nodded and smiled, whilst trying not to move one iota. A third paramedic joined us in the bedroom. He pointed out that the other two were allowed to give me Entonox which was in the back of the ambulance. I had three paramedics help get me down the stairs and out into the ambulance.

We arrived at the hospital and the ambulance reversed up to the door. I sucked faster and faster on the Entonox. The plastic mouthpiece was chewed up like a dog’s toy. I was wheeled out into cold air and straight into a blue curtained triage area. A surly nurse told the ambulance crew I’d be put into the corridor. They were surprised where I was going since no assessment had yet been made. I then had my observations taken with the blood pressure cuff loosely put around my wrist. 

I was sent on my way into the narrow corridor. We passed another trolley with an elderly lady who looked tired, then another elderly man, and on and on. I arrived at space number nine. A cheap sign had been printed out showing a number nine. I thought that I had to wait until the other eight patients had been moved onto wards or treated and discharged. My heart sank. It was to sink much further. A doctor arrived aged perhaps mid-twenties who had sunken eyes betraying a man who has had little sleep. He explained that my trolley ranking of nine had nothing to do with when I might get a bed. It was all decided upon priority which was understandable until the penny dropped that my priority might take a long time or never. 

An elderly man lying on a trolley was wheeled past me. He was number ten. He was bald on top but had long grey and silver, wavy hair around his ears, cascading down to his shoulders. He had a chaotic beard and moustache that hadn’t been trimmed in a long while. He reminded me of a very old Leonardo di Vinci. A nurse arrived and asked him how he was feeling. As soon as he was manoeuvred into position, he began his tale.

“Hello, I was sitting by the riverbank fishing. I was looking to catch rudd or bream. You’ve got to have the right flies, you see. Just waiting for my mum and dad to pick me. The accident? Oh, I was driving. I had to stop suddenly. Felt this pain in my neck. I’m okay. Just waiting for my mum and dad to pick me. Are they here?”

Nurse in blue without a name badge arrived and proceeded to put a cannula in my elbow and tag me with a white hospital name badge. I thanked her.

These people are strangers to me. We automatically apply trust and confidence into anyone who is ‘medical’. They could have a history of domestic abuse or torturing puppies. They could be members of a neo-Nazi group or be a Stasi Communist. We have no idea. They don’t wear name badges and don’t offer their names. If we ask their name, they give only a first name. Even the police have to wear a badge number so they can be traced. As we have seen with Letby, Shipman and Allitt, there are medical staff who kill patients. Patients should have a right to know who is lauding over them, pumping them full of drugs, cutting them open and examining them in intimate places.

There are columns of people walking past all the time. This is the M25 of corridors. There are auxiliaries pushing carts for cleaning, nurses of every hue of blue with arms folded looking studiously ahead; consultants with stethoscopes around their necks wearing chinos and check patterned shirts carrying black briefcases looking like they are heading for rehearsals of ER or Casualty; then security men dressed all in black barking into walkie-talkies with coiled wires around their ears and a multitude of accoutrements on their shiny black belts; patients wander up and down looking lost; visitors wander up and down looking lost and then my doctor comes back. I note he isn’t wearing a name badge, but I’ve established he’s called Daniel.

A trolley is wheeled past. I glance over as it brushes my trolley. It is covered in blue tarpaulin. I think it looks odd. The two porters are talking.

“Game on Saturday will be close. Fingers crossed but City are good.”

“Yea, City should win but who knows.”

They disappear at the end of the corridor from whence I first came.

“Are they here yet?”

I hear a new disturbance.

“You are not putting that in me. I am not having that.” It is a female voice. “Please I don’t want that.”

Four staff now file into the side room signed CDU. It is like One Flew over the Cuckoo’s Nest. I try not to let it mentally rip away another bit of my sanity. I look around. Nothing has changed. 

I see Daniel with a rucksack pushing through the crowd.

“Excuse me, Daniel are you leaving?”

He looks dog tired and stammers. “Er. Yes. I’ve briefed my colleague, Elias, who is taking over.”

I’m thinking then why couldn’t he stop and tell me that? “Right, well thank you.”

I doze off and another hour passes. I glance down the corridor and see a trolley pushed by two porters. The blue tarpaulin has risen to show the outline of a body. I realise it is a corpse underneath. The trolley is pushed next to me so that staff can squeeze through on the other side. I am inches from a dead person.

“Still fancy City. Haaland will score.” The porter is chewing gum and looking at his phone. Finally, they pull away. I feel sick.

I have been lying on the trolley for seven hours. It isn’t comfortable. The mattress is an upgrade on the ambulance mattress, but it isn’t designed to be lain on for hour after hour. I can no longer get comfortable. 

I see a man in blue pyjamas walking past looking up at the wall with the homemade signs.


“Yes. Is it Elias?”

He is surprised I know his name. “Yea. I’m your doctor.”

“So is there an update? Will I be admitted?”

He pulls out a folded piece of blank A4 paper. 

“What is your surname?”

“You’ll have it on my records but it’s Marsden”.

He writes it down and starts asking me what’s happened, and I tell him all over again. Clearly, he has no idea who I am or my medical condition.

“Erm, well we might, but we might send you home.”

“Okay, but when will you know? I’ve been lying here for six hours.”

He sighs and pauses and bites the top of his pen.

“Well. We. I am not sure.”

I can’t believe a doctor is standing in front of me and causally says I might be discharged. 

Elias has disappeared down the corridor. I am given my usual tablets, but they don’t have the right dosage, so they give me twelve tiny capsules instead of one. I am haunted with the thought, ‘When will I be admitted?’ Should I go home. My wife stops a staff member in the corridor.

“I’m a nurse, so what’s the problem?” I’m looking at her fake tan and the latticework, snake and writing spiralling around her arm. 

“I’ve been lying here for seven hours, and I just want to know when I’m going to get admitted to a bed?”

She lets out a stifled laugh. “Seven hours? I’ve just admitted a man who was here for twenty-four hours.” She shakes her head.

“I see, so there is no chance I’m going to get a bed?”

She’s gone in the medley of the traipsing crowd. I shake my head. There is no chance of me getting a bed which means I’m expected to sleep in this corridor overnight. I’ve had enough. The paracetamol nurse appears.

“What’s the matter?”

“The other nurse has just said I have little chance of a bed and I could be here on this trolley until tomorrow lunchtime. I am going. Can you remove the cannula?”

She looks panic stricken and says she’ll get a doctor. I shrug and my wife passes my bag with clothes. I am about to stand when a doctor appears. He is wearing a happy smiley face badge saying he is ‘happy to help’. I can’t help but laugh at the ludicrous badge.

“I am not waiting any longer. I’ve been here seven hours, and a nurse has said that it is taking twenty-four hours to admit patients. I can’t stay here overnight. This place is a madhouse.”

“You need to calm down. I am the registrar.”

“I am perfectly calm, but I am not staying here overnight. I am unwell and I need proper sleep.”

“So, er, what do you want?” He takes a long deliberate breath. “Tell me that. What do you want?

I now have a look of a teacher speaking to a difficult ten-year-old.

“I have told you. I want a bed. Can I be admitted?”

I now see the death cart trundling past again. I point to it.

“Look they’re pushing corpses past where patients are lying. Is that normal? Are you comfortable with that?”

The doctor looks at me and looks at the blue tarpaulin.

“I am going to see what is happening for you.”

He disappears and after fifteen minutes I really have had enough. I go to the dirty toilet with blood drops around the bowl and take off my pyjamas. It is a struggle to pull on a shirt. I finish after ten minutes and stare at the cannula in my arm. I carefully pull away the sticking plasters and draw the tube out of my vein and press hard with the plaster down on the entry point. I gather paper towels and squeeze them into a roll and wedge them into my dripping elbow.

I go out. My wife has my bags. As we walk away, the paracetamol nurse comes running.

“You need to sign out.”

I look at her. I am escaping the madness and I’m expected to sign that I am satisfied with it all. Which is the greater risk? Staying or going? The risk of staying is definitely greater, for both my physical and mental wellbeing.

“Has my mum and dad arrived?” I look at the old man once more then back to the paracetamol nurse.

“No, I am not signing anything.”

I go home. I’m back where I started. I can’t tell anyone this tale. People are sympathetic up to a point. It doesn’t mean they are heartless or cruel but as you start to explain the personal definition of pain, their eyes avert, and the grimaces appear as they picture my pain. Thirty seconds of explaining is usually the limit. Some people recoil after a few seconds of the vivid painting of pain, but none can stomach more than half a minute. Yet this companion of pain is living inside me all the time, waiting, biding its time, sneering at the painkillers I chew and laughing at the crutch I need to limp along.

Pain knows it will win. Maybe not the first minute or the first day. Maybe not after one week or one month, but it knows the inevitable. People can’t live with pain. People eventually surrender. People have their limits. Is mine eight months? Pain doesn’t want a confession. Pain doesn’t just want a truce or a ceasefire. Pain expects complete submission. Pain demands total victory. Occupation won’t suffice. No, pain’s terms of surrender dictate the taking of your soul. 


I once sat in a psychiatrist’s office with comfy armchairs and a large desk with photos of loved ones. On the wall were modern, abstract, meaningless paintings but there was also a framed poster. In the background this huge eagle was coming into land, talons outstretched and this evil look in its eyes. In the foreground was the back of this tiny mouse on two legs looking up the eagle. The mouse was showing two v-shaped fingers to this mighty power. Underneath the image of the eagle and the mouse were the words, ‘In the face of total disaster, the only recourse is complete defiance’. It’s the best plan I’ve heard so that’s what I will do. That’s what I am doing every day. No matter the odds, the only recourse is total, bloody defiance. There is no reason for it, I’m being defiant for the sake of being defiant. It is my soul saying, ‘Come on then, you think you’re so hard, well come and take me’. Tomorrow is another day. Today is total defiance. 

Paul W. B. Marsden was born into a working class family and now lives near Flint in north Wales with his wife Elena. He has three grown up children and he enjoys the opportunity to now mentor, advise and also learn from his adult children. Paul has previously had published a technical book with Routledge and self published local history books, poetry and aphorisms. Paul’s book Philosophers and the Meaning of Life will be published by Imprint Academic in early 2024. Paul’s career has taken him into banking, telecommunications, politics as a member of parliament, security management and construction. Paul is currently Head of Quality on the £5 billion rail improvement project in northwest England.