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Paul tried to avoid hip replacement as long as possible, but in 1999, after talking to several other young men who'd had the surgery, he decided to pursue it. We went together to see an orthopedic specialist, who showed us a picture of a healthy hip—a comfy, cushioned ball-and-socket fit. And then he showed us Paul's x-ray. No cushion—just one bone rubbing against another.

I shivered when I saw it. And I repented.

Being a young and strong man, Paul recuperated quickly and smoothly with a brand new titanium hip. Our marriage was more pleasant, with a brand new man playing the role of husband. But one morning in December 2002, Paul woke with the worst neck and shoulder pain he'd ever experienced. He attributed it to "sleeping funny" and made an appointment with a chiropractor. One look at an x-ray, and the chiropractor refused to touch him. The osteoarthritis had eroded the cartilage between Paul's vertebrae, causing them to shift alignment and crimp his spinal cord.

And that's how I ended up in the post-op room with Dr. Ross following Paul's spinal surgery. The cervical laminectomy opened several of Paul's vertebrae and relieved some of the pressure on his spine, but he's never fully been free from neck and shoulder pain since that day late in 2002.

Two years and a second hip replacement—on the other hip— later we joke about Paul being the Bionic Man. But chronic pain is no laughing matter for the sufferer or the family he or she lives with. In some ways, it's brought out the worst in Paul, me, and our marriage—Paul was one cranky man, I was one impatient woman, and neither of us talked about it. But it has also been the point from which we've had our greatest marital victories. It hasn't been easy for either of us; in fact, it's been downright, well—painful. But the marriage God has resurrected from the pain is evidence of his grace.

Pain taps the human capacity for compassion. We hear the cry, see the bruise, witness the physical reactions of the one in pain, and we respond. But what about pain from a hidden cause? When there is no painful event, visible bruise, or sudden yell—just month after month of pain from a source that isn't externally visible? Doctors Paul J. Donoghue and Mary E. Siegel call the source of this kind of pain Invisible Chronic Illness (ICI). In their book, Sick and Tired of Feeling Sick and Tired, they describe a much different human reaction to this kind of pain:

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