This summer, I had ophthalmic shingles. For a month, pain and I walked, as one nineteenth-century pain-sufferer put it, arm in arm. At the end of this cruel and unfair partnership, I still did not understand my companion, much as I wanted to. So when I heard about Joanna Bourke’s The Story of Pain: From Prayer to Painkillers, an accomplished account of our strange and often contradictory attempts to comprehend, communicate, and relieve pain, I had my next read set for me.
For some, pain is a living hell. For others, pain is a curative, a symptom of life. It can be a medium for both communion and solitude. For a few, pain is pleasure. There is no answer, then, to the question “What is pain?” And Bourke wisely avoids any attempt to make one up. Instead, she examines the “discourses, institutions, laws, and medical, scientific, historical and philosophical structures” to which our understandings of pain, and our pain itself, have been subjected. These understandings matter; they influence how we identify and treat pain. As we grapple with, and struggle to contain, a national opiate abuse epidemic—the result of an over-embrace of what Bourke calls “pills and potions promising the relief of pain”—this is a book that ought to be read widely.
We “can express the thoughts of Hamlet,” wrote Virginia Woolf in 1930, “but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.” Even acute agony is so shifty, vague, embodied, and (at times) transcendental, it defies meaningful description. Stub your toe and it’s hard not to be hyperbolic, if not blasphemous. People say a pain “feels like getting stabbed,” even if they have never been stabbed and therefore have no idea what it actually feels like to be stabbed. Henry Saul Zolinsky resorted, lyrically, if not effectively, to verse:
It is
The hush that falls
When screaming chords, drawn taut,
Break with a sudden snap!—and then
Recoil
People in Japan have “musk deer headaches,” and a hurting person in India might invoke “parched chickpeas.” The British “splitting headache!”—which was my mother’s go-to when we made a fuss—is no less peculiar. When trying to describe my shingles, I settled, in my delirium, to calling it “a jaunty hat of pain.” My uncle, who is fighting (bravely) against Lymphoma, says he feels that a cuckoo is trapped in his body, trying desperately to escape. I’m pretty sure he has never swallowed a live bird, and yet, like so many of Bourke’s sufferers, that’s as close as he can get to describing what he feels. As she points out, these descriptions, however bizarre and hyperbolic, still matter. By verbalizing how a pain feels, we are informing the way we feel it.
Grandparents everywhere will tell you that we’re not as tough as we used to be. Though Bourke, who admits to having a very low pain tolerance, hesitates to be declarative, the book lends credence to this view. While reading in Prospect Park about a particularly gruesome surgery on an un-anaesthetised pauper named Townend, (who was told by a doctor that a mere flinch might cost his life), I watched as a small boy, having been assailed by a bee, wailed impressively as though he’d lost a limb. Townend, meanwhile, didn’t peep as the doctor’s blade pierced his skin—the pain, which he channelled into a religious experience, “was exquisite.”
The Story of Pain is full of harrowing first-hand accounts of excruciating pain like Townend’s. This is not a book for the squeamish. Even the hardiest readers will squirm at some passages. Indeed, as Bourke points out, fMRI studies show that it is possible to experience physical pain just by witnessing it—and this book feels, at times, like proof of that.
But on balance, reading The Story of Pain is more pleasant than painful. Bourke has, for the most part, put together a fantastic, compelling, and engaging history. She writes scrupulously and generously. Her thesis, that pain can be better analyzed if thought of as an event, feels like an academic exercise—unnecessary and a little forced. Thankfully, within a hundred pages or so, she drops the argument and lets the primary sources guide her writing. This material is so rich, and the author’s connective tissue so fine, that it is easy to forgive the occasional clunky theoretical move, and focus instead on the action.
Bourke, whose previous titles include Fear: A Cultural History, is by training and reputation a chronicler of forgotten and downtrodden historical actors. When she turns her attention to the pain of these figures, especially in the final and best chapter, “Pain Relief,” she hits her stride. “There was and still is nothing democratic about pain,” she writes. The history of suffering and treatment is tied up with racism, classism, and sexism (just consider the phrase “take it like a man”). Bourke shows that the burden of suffering still falls disproportionately on women, minorities, and the impecunious. “Poor people can’t expect to drive a Rolls-Royce,” says one particularly unsympathetic anaesthesiologist, whom Bourke quotes, “so why should they expect to receive the Cadillac of anaesthesia for free?” It’s so unfair that it hurts, which is exactly Bourke’s point.
Arthur Holland Michel is a writer and editor living in Brooklyn. He is the codirector of the Center for the Study of the Drone at Bard College.