THE STORY OF PAIN

A scholarly treatise on how pain and those who suffer from it have been regarded over the past three centuries in the Western world.

Bourke (History/Birkbeck Coll., Univ. of London; What It Means to Be Human: Historical Reflections from the 1800s to the Present, 2011, etc.) claims that pain should not be considered an objective entity but rather as a unique part of a person’s being. As such, there is always a context, history or cultural milieu that colors the individual’s unique experience. That setting is her focus as she plumbs the literature and includes copious quotes from philosophers and practitioners, preachers and patients. It is infuriating to read that the Christian position was that pain was punishment for original sin (plus others you accrued) and that you had better grin and bear it if you hoped for a better hereafter. Or how about the phrenologists’ discovery of a “destruction” bump, which gave them the power to amputate mercilessly rather than show any hesitancy born of compassion in the pre-anesthetic days? Attitudes changed with the advent of ether and chloroform in the 1840s, but what about class, education or gender? Women were considered more sensitive and emotional, while the lower classes and blacks were considered inferior and less sensitive to pain (a great comfort to slave owners). It was not until the 1960s that medical practice came around to recognizing that newborns and infants could feel pain. To be sure, there were always voices raised against conventional beliefs, and there have been critical advances in the neuroscience of pain. Bourke charts this progress, but the truth remains: Medical education on pain is severely deficient, and race and gender issues continue to prevail. Patients themselves can be their own worst enemies, fearing addiction or condemnation as a complainer.

Bourke has done a fine job of detailing the story of pain and the folly it reveals. Sadly, the folly has not gone away.