It begins in the wee, quiet hours. You come awake, as if gently tapped on the shoulder. A whisper? Someone there? A muffled sound? Oh, well, maybe a dream. Deep breath, let the languor settle back in like a gossamer veil. But something is there, nagging. What is it? There, under the sternum, a dull ache, deep. Damn. Probably gas. Change position. No, roll over. No, roll back. Nope, getting worse. Much worse. Better walk it off. That’s a mistake. Better sit up straight. It’s bound to ease off, bound to, bound to, bound to . . . . . no, it intensifies, accelerates. . . . surely, it won’t. . . can’t get any wor. . .dear God. Stagger back to the bedroom, collapse in terror. Call 911. Panic city. This has to be the end. Tell the kids. . . tell the kids. . . remember. . . cremated. . . sorry . . . for . . . The EMS people ask questions, take vitals. Describe the pain? Mel. . . uh. . . uh. . . Gibson. . . Braveheart. . . drawn. . . quartered. . . only his. . . didn’t last. . . this. . . long. But this is . . .unnatural. Through clenched eyes, you peer down past heaving chest to convulsing abdomen — anticipating the horror of an alien raptor fetus erupting through your flesh. That’s silly. Get hold of yourself. At least die with dignity. The truth is you’ve been poisoned. More like arsenic. Blanche Moore has escaped from prison and she broke in to your house because you favor the death penalty. In the back of the meat wagon, it gets worse. Cold and stark. Like a big, square coffin. No shot, no pill, no oxygen. Bumping along through deserted, snow-covered streets. Why are they going so slow, Gertrude? THIS IS AN EMERGENCY. THIS IS MY LIFE.

Pain, they say, is relative. I guess that means pain is strictly in the mind of the beholder. Maybe so. Maybe a twinge for one person is agony for another. Some will say it depends on where it hurts. On the duration of anguish as well as the level. Are migraines the worst? What about back pain that slams you to the ground? To be fair, we should separate natural pain from the inflicted kind. For instance, as grueling as natural childbearing must be, it certainly can’t rank on the misery meter with torture. Thrown on the rack, nailed to a cross, boiled alive — now, these are inventions designed to make a body flinch. But who is in a position to rank pain anyway? Nobody. Hearsay is useless. Until a single individual experiences every method and manner of suffering and scientifically records the measurements, the best we can do is speculate on the hierarchy of pain. Even so, you submit the candidate above for the top ten. A double hit of acute pancreatitis and acute cholecystitis. Life threatening? Theoretically, yes. The most excruciating physical pain this side of the dentist’s office? It’s all relative. But a little advice. If there’s something out there more torturous, keep a 357 magnum handy.