There are four vital signs, four measured signs of our vitality, of our life
spark, the bzzzt of our body: temperature, pulse, respiration, blood pressure.
       T P R BP
       Tuck tongue for temp and two fingers no thumb on the radial wrist for
pulse and chest rise and chest fall for respiration and rip zip cuff for pressure.
       The four signs of our vitality: temperature, pulse, respiration, blood
       T P R BP.
       T P R BP.
       Plus one. Pain.
       Vital signs: temperature, pulse, respiration, blood pressure. And pain.
       Pain is the unofficial fifth vital sign, like,

       and sometimes Y.

       I can measure your vital signs. Celsius or Fahrenheit. Beats per minute.
Respirations per minute. Millimeters of mercury--systolic over diastolic.
       But your pain?
       Grimaces per minute? Tears per cubic centimeter? Aches over pains?
       No no no no. The only way to measure pain is to ask. Where does it hurt?

Is it a throb? Like needles? A burning? A knifing? Stabbing? Radiating? Pricking,
poking, in waves, a sharp pop crick crack tell me is it sore when I press here?

       Pain is subjective. On a scale of 1-10, one person’s 5 is another’s 8 is
another’ s 2 is someone’s like I’m in childbirth! is another’s just an ache, really.
       We can’t measure pain.
       We observe pain. We listen. We piece it together, the story of the pain.
The pieces of pain do matter.
       But we cannot measure pain.
       And yet pain in its immense immeasurability, in its inexactness, is a sign
of our vitality, our vital ability to live and draw a breath and beat blood; for our
heart to squeeze and sigh, the blue blood that spiders along our arms to our
hands, and we cuff and measure the thump thump, the blood beating, the beat of
our body.
       Pain is a sign of our vital ability, our vitality, to be hurt and to live and grow.
       When Sonja and Caleb tell me of Beautiful Response, I hear it in their
voice. The vitality. It’s a pulse on the radial wrist, a stethoscope on the brachial
arm; the thump-thumping. The lub-dub. The squeeze and sigh thumpa thumpa
thumpa, chest rise and chest fall, the deep breath. The oxygen.
       I hear it in their voice. Come to Uganda with us! Come and see.

       The vitality of it all, you two.
       Come to Uganda! you say.
       I say, Yeah. I’ll go with you. Of course I’ll go with you.
       To see what it is you are always telling about, you two. The vitality. The
vital ability of the Body to be sustained--through pain, through pulse, through
Of course I will go.
You’re paying, right?