From birth my first daughter’s eyes watered constantly. She rubbed and rubbed and rubbed at them, to no avail. Mira’s tear ducts were clogged, meaning that they couldn’t drain properly and frequently got infected. When we asked the doctor if it was hurting her, the answer was an unequivocal ‘No’. But, the doctor continued, the longer the problem persisted, the less likely it would resolve itself on its own.

So at about 14 months, we took Mira in to have her tear-ducts un-plugged. The procedure was simple (though not for her first time parents): a little anesthesia, a quick probe in each tear duct, two “pop”s, and that was it. Problem solved.

When she came home and the anesthesia had worn off, though, her baseline, overall mood seemed clearly to have made a quantum leap. We may have imagined it, in some sort of projective rationalization in response to the guilt of having put our baby under, but I don’t think so. She really did seem happier.

The experience set me to wondering about how young children experience pain: whether, at that age, the physical sensations they are born with just get rolled into their “normal” like so many other aspects of the lives they land in, or whether kids actually understand pain in some way similar to us adults.


The past three-plus weeks I’ve been grappling with a tremendous amount of physical pain, thanks first to a late-emerging post-operative staph infection in the site of a foot surgery I had in mid-November, then to a second surgery, and then to an antibiotic that wasn’t quite up to the job. Which has brought me back to thinking about pain. A lot.

In a low moment in the hospital I decided to list the various instances and types of pain I’ve experienced in my life, categorizing and trying to rate them (excessive physical pain most definitely brings my crazy to the surface). It’s navel-gazing stuff that only the bored and unfocused (and drug-addled) can bother with, but my effort at classification does speak to some of the existential angst that can ride on the heels of intense, unpleasant, irremediable hurt: your are unable to control the one physical thing that is totally and undeniably yours — your body; you are powerless in the face of an insanely strong and unbending force; and you are completely alone in the knowledge that the pain is your and yours alone — that others (and even you, later) may have some inkling of the intensity, sorta kinda, but that you and you alone are living it, right here and now. If anybody REALLY understood, they would never take so long to answer the call button — or to retrieve your meds. (A selfish and childish urgency? Yes. But real? Yes again.)

All this, too, got me thinking about how pain and its near-cousins (fear, loneliness, etc.) are handled in children’s literature. Not surprisingly, the physical stuff is pretty hard to capture or convey. But other sorts of pain — the emotional, psychological (and, yes, existential) — under-gird a lot of the books that impact me most strongly. Don’t get me wrong: I love silly books, beautiful books, books that surprise and books that are informational. But the books that trade in pain get hold of me and hang on in a totally different way.


I borrowed a copy of David Almond’s Skellig from Mira (now 11 years old) last week. I’d read the prequel, My Name Is Mina, over the summer, and loved it; Skellig did not disappoint. The book is about nothing if not fear and pain — of losing a sister, of a family out of control. And at the same time it is a story about beauty, connection, dreams, love, birds, angels, looking and seeing and being present, and all manner of other important stuff.

When I was little I was a big fan of Evaline Ness’s picture book Sam Bangs and Moonshine. The motherless Sam is alone in the world and prone to talking “moonshine” — with one of her moonshine stories almost leading to the death of a young friend. Plenty of pain there.

Sam Bangs n Moonshine

It’s not for nothing that the percentage of orphans in kids’ books is so much higher than the percentage of orphans in the world at large. What is more painful to a child than losing — or the fear of losing — his or her parents? Likewise, stories about not fitting in — about thinking differently, looking different, living different, being different — abound.

And kids are drawn to the books that take on this heavy stuff (so much the better if the author is able to mix in some humour too). Finding a mirror for one’s own pain and fears and feelings of isolation is a powerful way into story. And learning empathy in the process is a great gift too: we are raising these small people to be adults, after all, and empathy is important.

Speaking of which: at another low moment in the hospital I fantasized about, how, when I was released and healthy again, I would invent a pain simulator for doctors and nurses that would render that fuzzy “where is your pain on a scale of 1 to 10” question obsolete. My simulator would instead allow patients to simply wire themselves to their caregivers for a moment or two so that the caregivers could truly feel patients’ pain levels. That way you might achieve something closer to true empathy. And, you probably wouldn’t have to wait forty-five minutes for your percocet either.


  1. very good. I was diagnosed with Crohn’s when I was 31, and suddenly a lot of questions (why are you so irritable/depressed/etc) were answered. And having abdominal pain no longer meant I was deficient in coping skills.

    1. Emma- It must’ve been such a relief to sort it out — and to just get on with the work of learning to live with Crohn’s (though I know that has its own load of challenges). You’re reminding me of an episode of the radio show This American Life that I heard years ago, about the impact of finally having a name for things that were previously amorphous and undefined — but very much there. If you commute or do podcasts or whatever, check it out:

      Thanks for reading!

  2. LOVE your idea of a pain simulator. Especially handy when your child’s pain levels operate from 1-5 (not 1-10) so a “4” garners very little response from the doctors & nurses. Your invention would indeed bring relief and empathy MUCH sooner. Hope you totally heal soon!

  3. I had a staph infection in my hand last year and I can tell you, it was the loneliest feeling in the world. Especially in the middle of the night, when I wanted to wake everyone up to tell them EXACTLY HOW MUCH IT HURT, but I couldn’t because what was the point? If I’d had your pain simulator, however, I would’ve wired everyone right up. I think it’s worse for babies because all they can do is shriek, and we misunderstand and change their diaper over and over again when what they really need is a teething ring.

    Skellig is the best. 🙂

    1. it’s so counterintuitive right? people really are nice and sympathetic, but it is still so alienating….
      a bit like how being home with babies could sometimes be….

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