People are always asking me why I write about extreme forms of violence. I know their subtext: “Why is a mild-mannered woman like you so obsessed with hatred, dismembered bodies, and killing?”
In all honesty, I don’t know what draws me to these topics. Bloodthirsty aggression is just so interesting. This is why, a few years ago, I surprised my friends by announcing that I was going to write about pain. Crucially, this book was not about inflicting pain, but rather about the experience of suffering it.
I know the exact moment I made this decision: I had been in hospital after a serious operation and was, to put it mildly, in agony. My morphine pump wasn’t working. Stupidly, perhaps, I was anxious to be a “good patient” to the overworked night nurses, so I was determined not to complain. Instead, I focused on my breathing. A friend had given me a slim book to read, so I opened it in an attempt to distract myself.
It was Virginia Woolf’s 1926 essay On Being Ill. In it, she argues that people can draw on rich, literary languages when attempting to describe how it feels to be in love, but possess only a thin language when talking about pain. Lamenting the “poverty of the language” of pain, she observes that every schoolgirl who falls in love “has Shakespeare and Keats to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry”. There is something about physical pain that is incommunicable, even “beyond language”. I was riveted.
An hour or so later, my partner arrived at my bedside and I remember telling him about Woolf’s argument concerning the inexpressibility of suffering. As I spoke, I noticed him beginning to smile. Did I realise, he said, that I had been speaking non-stop for 40 minutes about the inability of people-in-pain to talk about what they were going through? Perhaps it is not that people-in-pain find it impossible to communicate their suffering but that witnesses to pain don’t want to hear.
That was the moment I decided to write The Story of Pain: From Prayer to Painkillers. How did people in the past talk about suffering? I began collecting diaries, letters and memoirs written by people living between the 18th century and the present who were suffering from all kinds of painful ailments. The most striking feature of the earlier accounts was the centrality of religious languages. For Jews and Christians – whether “true” believers or not – religious texts provided rich narratives of suffering, from Job to Jonah, the Psalms to Jeremiah. Christians turned to the sufferings of Christ to speak their agony. Sufferers only needed to cry out to “Him Whose Blood-sweat dyed Gethsemane!” and plead, “Forgive me, Lord, who caused Thee agony / Ten thousand times and hear my anguish’d prayer.”
This is a world away from the secular ways of speaking about pain that are prominent today. In modern times, the arrows of pain are not flung by an infuriated deity but are the tools of retribution inflicted by a penetrating germ, or the result of a lifetime of “bad habits”. Instead of surrendering ourselves to pain, people-in-pain are encouraged to “don their armour” and fight.
Modern sufferers (more typically characterised as “patients”) are no less eloquent as a result. As one paraplegic explained, he felt as if “a family of snakes” were “squirming” in his buttocks. In the words of a man suffering chronic back pain, “my back hurt so bad I felt like I had a large grapefruit down about the curve of the back”. Even more creatively, one woman described her chronic headache as feeling “like a bowl of Screaming Yellow Zonkers popping hard behind my forehead”. She was clearly familiar with that 1960s snack made of popcorn coated in a sweet yellow glace.
Young children also possess extremely rich, figurative pain-languages. They might describe their pain as “a war in my stomach”, “lots of banging”, “cymbals clapping”, “grody to the max” and “like mosquitoes poking around”. Or, as one six-year-old child eloquently put it: “Whenever my ears start to pain, I lose my smile and feel bad.”
These patients’ depictions of pain might be imprecise and their metaphors mixed, but they are evocative nonetheless. Witnesses to pain instinctively grasp the meaning of their descriptions, even though few of us really know what it feels like to be gnawed by rats, stabbed with a poker, or bitten by dogs.
Rich descriptions of pain – both in the past and today – attempt to make sense of what can seem like senseless suffering. As I discovered lying in my hopsital bed, speaking about suffering helps cope with it. It also provide hints for witnesses about how they can reach out to help.
Extract
Pain does not emerge naturally from physiological processes, but in negotiation with social worlds. From the moment of birth, infants are initiated into cultures of pain. Some infants are dragged from the womb with forceps. Many have their heels pressed to force that first raw breath; others have synthetic pumps plunged into their noses, sucking up mucous. As the infant matures, people responsible for its socialisation pay attention to some tears and not others. Hands are smacked as they reach for flames. Some cuts are kissed better; some bruises overlooked. It makes a difference if you are a boy. It matters if you are poor. People-in-pain learn how to “suffer silently” or “kick up a fuss”. In reaching out to people-in-pain, we must always seek to identify the needs and desires of people located within specific times and places. A painful world is still a world of meaning. History can help in this process. By knowing how people in the past have coped with painful ailments, perhaps we can learn to “suffer better”.
More about the book
“The Story of Pain traces the slow process by which the medical professions have come to accept responsibility for the management of pain. But it also reminds us that the goal remains elusive. The measurement of pain is a difficult matter. The traditional method depends on asking patients to rate their suffering, perhaps on a scale from one to 10, or by responding to some kind of questionnaire. But these approaches are liable to be distorted by self-pity or misplaced heroism, not to mention deliberate dishonesty, and in the last 50 years there have been concerted efforts to devise objective scientific measures of pain. An early technique called infrared imaging thermography was supposed to give doctors a “physiological equivalence of pain” by measuring variations in skin temperature, and more recently various forms of brain imaging have been promoted as taking the guesswork and subjectivity out of pain detection. But the problem will not go away: when patients dispute a scientific estimate of their suffering, who is to act as referee?” - Jonathan Rée. Read the full review.
Buy the book
Joanna Bourke’s The Story of Pain: From Prayer to Painkillers is published by Oxford University Press at £10.99 and is available from the Guardian Bookshop for £9.34.
