The back pain is livid in the southeastern quadrant of my back. Because it is inside of my body, not manifest like an abrasion, it is my secret horrid companion. The only kind of interruption in my story is its absence, a clarity that makes me reverential for absence. The source of the pain is an occupation of scar tissue, a furious parasite on the muscles that connect my lumbar spine to my hip. I have no disease or syndrome. The spine is the center of the body, the brain’s “information highway.” Yet, it is also the organ most easily distended by the rigors of chairs and running routines and standing up for hours and deep inside my body, under all its layers, it is my fixation, my base.

I am asked again and again: Was there ever an injury?

I once was a waitress. I held twenty-pound trays of food over my right shoulder. I was young and strong. I slipped on some lettuce. I also danced in four-inch platforms. I ran on concrete with worn-out Nikes. I slept on terribly worn mattresses and have never held my head up unless scolded about my posture. I’ve carried two children in my belly and did nothing to accommodate the burden. Not one injury, but a constant assault, indifference. I damaged my spine, the muscles that held it straight, and the nerves that told the stories to the rest of me. Sometimes my back hurts and I hear it as a ring in my ears, feel it as a twitch in my fingers.

The spine is wasted on the young.

Some people get back pain because their bodies hunch over machines all day. Some people turn to look at their neighbor’s dog and trap their spine’s cushions or just a little cold gust of wind and then two days in bed, in traction, in pharmaceutical ether.

This back pain puts me in league with the plumber and the nurse. With the nun and the bus driver on disability. The lawyer who brings the masseuse into his office every Tuesday. The pain costs the United States sixteen billion dollars a year. How is one productive when bent into an origami muscle crane? A democratic condition, benign and varied. I want a colored ribbon for it, the reddest saffron tinged with mud.

My husband and his father bond over golf scores and baseball stats and my father-in-law and I share stories about lying on the floor with pillows under our knees, about stretching and pulling, pain as our common territory. Besides my own name, spasm is the word I Google the most.

I wish it onto someone else.

John F. Kennedy suffered from crippling back pain that he hid from the populace. He wore a back brace and carried a “medicine bag” wherever he went and would walk across the tarmac of an airport until he could get to a spot where no one could see him, covered in sweat from walking through his pain, waving and smiling. It was the shame of his back pain, and he worked through it, and he invented the Peace Corp. and put a man on the moon, so who am I to call in sick to work because “my back is in spasm?” I am weak, so how should I presume?

When I reach into language, all I find is a low-slung moan, primeval and universal.

Ten years ago, while teaching a composition class, my back gave out, and I couldn’t stand or sit. I canceled class for the rest of the day and a friend drove me to the doctor who gave me a stack of scripts for medicines that dulled the pain, loosened my muscles and numbed me of the anxiety that folded me. It was the best my back ever felt. I often want that day back without the synthetic sublimity. It has become the locus of normal. Absence as presence.

In a dense bubble of sleep, I dream of a cartoon building wrapped in ivy flapping with fire and smoke. I see a paper princess clawing at the briar that traps her whole body into her bed. My psychotherapist calls it a metaphor for a session or two then the metaphor becomes fleshy, becomes my body because symbolic smoke comes out of my ears, that is, I twist and rub my neck while she and I talk, and my metaphorical flesh tears from the thorns.

My back is a tense network of psychic injuries.

Pain is a strangely female terrain, perhaps because female bodies are sometimes burdened with childbirth, but also because our bodies shed blood; we are walking wounds. Our bodies are also targets; we get toppled and knocked about and our bodies become curio cabinets of these assaults, real and imagined. My psychotherapist asks me if I’d ever been sexually abused; apparently there’s a correlation between chronic back pain and a history of abuse.

Good touch. Bad touch.

I have not, I answer, but then I imagine my back as a map of psychological trauma, islands of the injury of being. I name each location. The spot at the very base of my neck I call “The Island of Workplace Pariah-ship” and the lock on my hip becomes the “Petty Injustices of Beauty versus Aging.” The knot under my scapula I call “Childhood” because it seems the most substantial. All of it is a scheme, a theme, a system of the untenable.

My shoulders rise like the scruff of a threatened coyote when I am insulted or when I feel insulted. They’re like boulders, I am told.

The cure evades me. I’ve seen so many doctors and massage therapists and acupuncturists and orthopedists and family physicians; they have nothing to offer me, no diagnosis, no solution. I can only pray against the dowager’s hump, spinal fusion, slipped disc. Some prescribe panaceas that are lovely because of their usefulness and some that are torture because of their inefficacy. The physicians warn me of the dangers of the cure, but when I am set to sleep, the rigid clamp of my ligaments softened in surrender, I feel that I have won. Still, the cure is occasional and temperamental. Some mornings I wake up and my body is worse.

Parables of hopelessness, I denounce you. I don’t know how to think my way out of this one.

When my back doesn’t hurt, I analyze my physical body as if it were a violin, annotate how my strings are tuned. I try to retain the moment of painlessness in the same places I store my first kiss and my first published poem. Into the box of triumphs.

I’d like to perform my own autopsy to see what this pain complex might look like, to see the muscles and their perforations. There are fleshy pouches of scar tissue on the very top of my sacrum. I want to see their color, their substance. I’d like to compare my back to a healthy back and note the lack or the excess. What is the humor of my back pain? I think it is fire.

Each time I rub a spot, I make the pain bigger. It reproduces. My pain is a spore.

I call for the atrophied heat of my dream-mother’s hands. When I would thrash in bed because of the pain, she would rub salves into my back until I fell asleep. Sometimes I reach around to my back as if I could heal myself. Author, heal thyself. If I just rub one section of my back, I think, or twist a certain way, the pain might simply disappear, never to come back. This is never true. There is no spot, no button that can undo the tangle.

I work my core. The effort as tiny teaspoon carried up a mountain.

My back is a second face I cannot see and it grimaces and frowns to express its disgust at the vagaries of the mundane. Agitation: my back senses the approach of touch. My back flinches, the third eye closes. Glee and the face goes slack. How many muscles does it take to make my back smile?

The pain cultivates a different type of narcissism in me. I gaze and search inside of myself for hours. Sometimes I am in awe of its brutality. I am inside of myself and inside the pain and I can’t get out. Fallen into the current of the pain and I can’t get out. All pain, only pain. One word for every register, each nuance, every height and depth. Always talking of it, asking after it. Here I am writing an ode to the pain.

It is my entire world or my world gets tucked deep inside the well of it. I peer over its wall. Carmen was here. I am missed. I miss.

I give each episode a name like we do hurricanes—they have the same capacity for destruction and randomness. Hello, Pandora. I hope you don’t stay too long. And you, Francesca, you seem to favor the shoulder.

The pain is a ghost, so some are skeptical. I don’t blame them because I am skeptical too. I suspect a part of me is inventing the pain for attention, for confirmation that I am a body. One time I sat with it as if it were a photograph, something from in the world. This is what I saw: storm-torn branch with silver slivers left in ice. A coiled snake that stretches into the mouse hole where there is little room for occupancy. The remnants of a house fire, a piece of chair that, in its center, preserves the orange glow of acceleration.

Then, occasional respite. Someday I will have to decide which is the gap, the pain or the absence of the pain because other themes engage me: my mothering, my teaching, the herbs I grow in my garden, politics, feminism, oil spills, foreclosures. My back dissolves into normal, and I am humble. Dissipation brushes through me like a brusque stranger—

Carmen Giménez Smith is assistant professor of creative writing at New Mexico State University, publisher for Noemi Press and Editor-in-Chief of Puerto Del Sol and the author of Odalisque in Pieces (University of Arizona, 2009). Her work has most recently appeared in Ploughshares, Colorado Review and jubilat, and forthcoming in A Public Space and Denver Quarterly. A memoir, Bring Down the Little Birds, will be published by University of Arizona Press in 2010.

World More World than World