The Pain Chronicles

by Melanie Thernstrom

  damage the median nerves that supply the hands: See discussion in Vertosick, Why We Hurt, 159.

  “to suffer little things now”: See Thomas à Kempis, The Imitation of Christ (Milwaukee: Dover, 2003), 24.

  “Allow me to be eaten by the beasts”: William A. Jurgens, Faith of the Early Fathers (Collegeville, Minn.: Liturgical Press, 1970), 22.

  Cosmas and Damian: See Sabine Baring-Gold, Lives of the Saints (London: Hodges, 1882), 397–401.

  “when he was black in the mouth”: See John Foxe, Foxe’s Book of Martyrs (Grand Rapids, Mich.: Zondervan, 1978), 212–15.

  “When the blazing fire does not burn”: The Law Code of Manu, Patrick Olivelle, trans. (New York: Oxford University Press, 2009), 119.

  King Athelstan: See Hunt Janin, Medieval Justice (Jefferson, N.C.: McFarland, 2004), 14–15 and also Katherine Fischer Drew, Magna Carta (Westport, Conn.: Greenwood, 2004), 163.

  Babylonian river ordeal: See Gwendolyn Leick, The Babylonians (New York: Routledge, 2003), 163.

  ordeals finally gave way to trial by jury: Robert Von Moschzisker, Trial by Jury (Philadelphia: Geo T. Bisel, 1922), 40. See also Daniel Friedmann, To Kill and Take Possession: Law, Morality and Society in Biblical Stories (Peabody, Mass.: Hendrickson, 2002), 21.

  “The witch is executed”: See Ariel Glucklich, Sacred Pain (New York: Oxford University Press, 2001), 41.

  “‘What are you doing at the moment?’”: Daudet, In the Land of Pain, 1.

  “Pain strengthens the religious person’s bond”: See Glucklich, Sacred Pain, 6.

  “deciphers it with his wounds”: See Franz Kafka, The Metamorphosis, In the Penal Colony, and Other Stories, Joachim Neugroschel, trans. (New York: Simon & Schuster, 2000), 205 ff.

  “When pain transgresses the limits”: Cited in Glucklich, Sacred Pain, 23.

  “the sweetness of this greatest pain”: Ibid., 206.

  “one’s own physical pain” and “another person’s physical pain”: Scarry, The Body in Pain, 3 and 4.

  II. THE SPELL OF SURGICAL SLEEP: PAIN AS HISTORY

  “WE HAVE CONQUERED PAIN”: See John Saunders, The People’s Journal 3 (London: People’s Journal Office, 1847): 25.

  “nothing so horrible as toothache”: Heinrich Heine, Works, Volume 4, trans. Charles Godfrey Leland (New York: Dutton, 1906), 141.

  pain required interpretation: This is clear in many of the well-known texts of these religious traditions. For example, in Saint Augustine’s Confessions, written in the fourth century C.E., he speaks of pain as sometimes physical and sometimes spiritual, but his metaphors often blend them. Speaking of his spiritual pain, he writes of his relationship to God as a physical cure: “Under the secret touch of your healing hand my swelling pride subsided, and day by day the pain I suffered brought me health, like an ointment which stung but cleared the confusion and darkness from the eye of my mind.” See Confessions (New York: Penguin, 1961), 144.

  Brutality began to recede: The beginning of the nineteenth century saw many such reforms. Britain ended its slave trade in 1807 and in the following decades, a series of legislative acts began to restrict child labor.

  Christianity itself was influenced: For a more extensive discussion, see Lucy Bending’s The Representation of Bodily Pain in Late Nineteenth-Century English Culture (New York: Oxford University Press, 2000).

  they die painlessly: In Jane Eyre, Helen Burns, dying of consumption, tells Jane, “We must all die one day, and the illness which is removing me is not painful; it is gentle and gradual: my mind is at rest.” Jane sleeps through the moment of her death, so it is not described. In Dickens’s Old Curiosity Shop, he forgoes describing Little Nell’s passing and gently lingers instead on her corpse: “No sleep so beautiful and calm, so free from trace of pain, so fair to look upon. She seemed a creature fresh from the hand of God, and waiting for the breath of life; not one who had lived and suffered death.”

  “robbed of its terrors”: René Fülöp-Miller, Triumph Over Pain (New York: Literary Guild of America, 1938), 150.

  How terrible surgery had been: See discussion in Peter Stanley, For Fear of Pain: British Surgery 1790–1840 (Amsterdam: Rodopi B.V., 2003), 317.

  “an armed savage who attempts to get that by force”: John Hunter, “Lectures on the Principles of Surgery” in The Works of John Hunter (London: Longman, 1835), 210.

  body’s integrity was so well guarded by pain: See the discussion of development of surgery in Dormandy’s The Worst of Evils and in Stanley’s For Fear of Pain.

  “moving, bleeding flesh”: Quoted in Stanley, For Fear of Pain, 190.

  “amputate a shoulder in the time”: Quoted in S. A. Hoffman, Under the Ether Dome (New York: Charles Scribner and Sons, 1986), 266.

  “spoil a hatful of eyes”: Robert Brudenell Carter, “Lectures on Operative Ophthalmic Surgery,” The Lancet (April 13, 1872): 495.

  mortality owing to amputation at the thigh: James Young Simpson, Anesthesia, Hospitalism, Hemaphroditism, and a Proposal to Stamp Out Small-Pox and Other Contagious Diseases (Boston: Adam and Charles Black, 1871), 95.

  “How often have I dreaded”: Valentine Mott, Pain and Anaesthetics: An Essay (Government Printing Office, 1862), 11.

  surgeons were typically of the lower class: See Francis Michael Longstreth Thompson, The Cambridge Social History of Britain 1750–1950: Social Agencies and Institutions (Cambridge: Cambridge University Press, 1993), 176–77.

  helped dissuade Charles Darwin: Charles Darwin, Autobiographies (London: Penguin, 2002), 21.

  “resolute and merciless”: Quoted in Ian Dawson, Renaissance Medicine (Brooklyn: Enchanted Lion Books, 2005), 43.

  “indications of the patient’s state of mind”: Cited in Dormandy, The Worst of Evils, 108.

  gangrene: See Frank M. Freemon, Gangrene and Glory (Madison, N.J.: Fairleigh Dickinson University Press, 1998), 46–49, for a detailed account of the treatment of wounds during the Civil War.

  “during the operation”: Jonathan Warren quoted in Glucklich, Sacred Pain, 181.

  “Oh no, for mammy has told me that I ought”: John Abernethy, The Hunterian Oration (London: Longman Hurst, 1819), 62, as cited in Stanley, For Fear of Pain, 254.

  patient of Dr. Robert Keate’s: See Stanley, For Fear of Pain, 265.

  amputation of his foot in 1842: Wilson describes his experience in a letter to anesthesia pioneer James Simpson, printed in The Obstetric Memoirs and Contributions of James Y. Simpson, ed. by W. O. Priestley and H. R. Storer (Philadelphia: J. B. Lippincott & Co., 1856), 712.

  1812 letter by the English novelist and memoirist Fanny Burney: See Fanny Burney, Journals and Letters (New York: Penguin, 2001), 431–44. Although the letter is addressed to her sister, Fanny had both her husband and teenage son copy her draft over to make a clean version, so it seems to have been written partly to share her experience with them—knowledge she had kept from them at the time of the operation.

  doctors most likely did not actually examine her breast: See Claire Harman, Fanny Burney: A Biography (New York: Alfred A. Knopf, 2001), 290.

  “no half-measures will answer”: Quoted in Dormandy, The Worst of Evils, 172.

  punching him on the chin: As Dr. Larrey tells it, upon coming to consciousness, the colonel sputtered that the doctor had not behaved as a gentleman, but had taken “cowardly advantage” of his temporary incapacity. Dr. Larrey explained that he knew “the insult would temporarily distract,” showed the colonel the bullet he had removed from his foot, and asked him to shake hands. See Dormandy, The Worst of Evils, 1.

  “refrigeration anesthesia”: Also known as “cryoanalgesia.” Garotting—another technique of the day—involved cutting off the head’s blood supply by compressing the carotid artery until the patient fainted. Practiced aggressively, it could cause brain damage; practiced cautiously, it risked too short a spell of unconsciousness for a complete surgery.

  “cut and [he] will feel nothing”: Arnold of Villanova, quoted in William John Bishop, The Early History of Surger
y (New York: Barnes and Noble, 1995), 60. See also Henry Smith Williams and Edward Huntington Williams, A History of Science: The Beginnings (New York: Harper and Brothers, 1904), 35.

  Henbane and mandrake were too dangerous: “Whoso useth more than four leaves shall be in danger to sleepe without waking,” a medieval text cautioned of henbane. See Sidney Beisly, Shakespeare’s Garden, or the Plants and Flowers Named in His Works Described (London: Longman, Green, Longman, Roberts & Green, 1864), 87.

  Opium is the oldest and most important medicinal substance: See Booth, Opium: A History, 15.

  “Many a penny”: Elizabeth Gaskell,Mary Barton (New York: Penguin, 1996), 58.

  Greek word for shapes: See discussion in Dormandy, The Worst of Evils, 255.

  Diocles of Carystos: Quoted in Ibid., 24. His name is also spelled Carystus.

  “God’s own medicine”: Sir William Osler quoted in Michael Bliss, William Osler: A Life in Medicine (New York: Oxford University Press, 1999), 365.

  “causeth deepe deadly sleapes”: William Bullein, Bullein’s Bulwarke of Defence Against All Sickness Soarenesse and Woundes That Doe Dayly Assaulte Mankinde (1579), quoted in Booth, Opium: A History, 26.

  higher survival rate after ancient Peruvian trepanations: See discussion in Richard Rudgley, Lost Civilizations of the Stone Age (New York: Simon & Schuster, 2000), 131.

  compensate their slaves with more cocaine: See Steven B. Karch, A History of Cocaine (London: Royal Society of Medicine Press, 2003), 17.

  “When anyone suffers from toothache”: Cited in Donald Meichenbaum, Cognitive-Behavior Modification (New York: Springer, 1977), 170–71.

  “the blessed delight”: Quoted in Fülöp-Miller, Triumph Over Pain, 19.

  “I was absent from that part”: Dhan Gopal Mukerji, My Brother’s Face, quoted in E. S. Ellis, Ancient Anodynes: Primitive Anesthesia and Allied Conditions (London: W. Heinemann, 1946), 18.

  “I soon had recourse”: Immanuel Kant, Religion and Rational Theology, trans. Allen W. Wood, George Di Giovanni (Cambridge: Cambridge University Press, 2001), 320–21.

  mesmerism: See Alison Winter, Mesmerized: Powers of Mind in Victorian Britain (Chicago: University of Chicago Press, 2000), and a briefer discussion in Dormandy’s The Worst of Evils, 195–99.

  “This Yankee dodge”: Quoted in Stanley, For Fear of Pain, 294.

  “There can be few”: Ibid., 290.

  “These phenomena I know to be real . . . independent of imagination”: Ibid., 289.

  “a ready abandonment of the will”: See Blackwood’s Edinburgh Magazine 70 (1851): 84–85.

  “immoral tendency”: James Braid, Neurypnology; or, The Rationale of Nervous Sleep, Considered in Relation with Animal Magnetism (London: John Churchill, 1843), 75–76. Braid distinguishes his practice of hypnotism from that of mesmerists because his practice does not depend on the magnetic emanations—or any other power—of the hypnotist.

  E. M. Papper theorizes: E. M. Papper, Romance, Poetry, and Surgical Sleep: Literature Influences Medicine (Westport, Conn.: Greenwood Press, 1995), 136.

  “necessary to our existence”: Quoted in Stanley, For Fear of Pain, 283.

  “To escape pain in surgical operations”: Quoted in “A History of the Gift of Painless Surgery” in The Atlantic Monthly 78 (1896): 679.

  “appears capable of destroying physical pain”: Cited in Paul G. Barash, et al., Clinical Anesthesia (Philadelphia: Lippincott Williams & Wilkins, 2009), 5.

  “the air in heaven”: See Martin S. Pernick, A Calculus of Suffering (New York: Columbia University Press, 1987), 64.

  Ether frolics became the rage: Ibid., 64–65.

  “In science the credit goes”: Cited in William Osler, Counsels and Ideals from the Writings of William Osler (Boston: Houghton Mifflin, 1921), 294.

  at least three Americans were experimenting: For accounts of these experiments, see Dormandy, The Worst of Evils, 202–26.

  doctor from Georgia: In 1842 Crawford Long, of Danielsville, Georgia, excised a cyst from a patient’s neck using ether anesthesia.

  “the wonderful dream”: Johann Friedrich Dieffenbach, quoted in “Pain Relief: Fact or Fancy?” by Prithvi Raj, Regional Anesthesia and Pain Medicine 15 (July/August, 1990): 157–69.

  “The discovery that the inhaling”: Henry Jacob Bigelow, “Address at the Dedication of the Ether Monument,” in Surgical Anesthesia; Addresses, and Other Papers (Boston: Little, Brown and Co., 1900), 101.

  “questionable attempt to abrogate” and “destruction of consciousness”: These criticisms are from physicians’ letters cited in The Obstetric Memoirs and Contributions of James Y. Simpson, 616. Simpson responds in defense of the benefits of anesthesia. See also general discussion in Pernick, A Calculus of Suffering.

  “this would not be worth the consideration”: Cited in Betty MacQuitty, Victory Over Pain: Morton’s Discovery of Anesthesia (New York: Taplinger, 1971), 42.

  “the insensibility of the patient ”: See Military Medical and Surgical Essays: Prepared for the United States Sanitary Commission (Philadelphia: J. B. Lippincott & Co., 1864), 393.

  “a mere operator”: See Edward Lawrie, “The Teaching of Anesthetics” in The Lancet 157 (1901): 65.

  “a remedy of doubtful safety”: Isaac Parish, “Annual Report on Surgery, read before the College of Physicians” (College of Physicians of Philadelphia, November 2, 1847).

  “Pain during operations”: See “Injurious Effects of the Inhalation of Ether,” Edinburgh Medical and Surgical Journal (July 1847): 258.

  “The shock of the knife”: See Stanley, For Fear of Pain, 305.

  “slavery of etherization”: Quoted in Glucklich, Sacred Pain, 188.

  Henry Bigelow himself soberly warned: Henry Bigelow, “Insensibility During Surgical Operations Produced by Inhalation,” in Boston Medical and Surgical Journal 35 (1846): 309–17.

  “perfect insensibility to pain”: See “Etherization in Surgical Operations,” The Lancet 49 (January 16, 1847): 75.

  Sir James Young Simpson pioneered the use of chloroform: See Stanley, For Fear of Pain, 302.

  “if the patient has a very great dread”: By the mid-1850s, Syme himself had become a proponent, insisting to other surgeons that pain “most injuriously exhausts the nervous energy of a weak patient.” See Linda Stratmann, Chloroform (Stroud, United Kingdom: History Press, 2003), 100.

  “Pain is the mother’s safety”: See discussion of labor pains in Charles D. Meigs, Obstetrics: The Science and the Art, 5th Edition (Philadelphia: Henry C. Lea, 1856), 372–73.

  in “toil”: See The Obstetric Memoirs and Contributions of James Y. Simpson, 549 and 551.

  “anesthesia à la Reine”: See Hannah Pakula, An Uncommon Woman (New York: Simon and Schuster, 1997), 123.

  “I dressed him, God healed him”: Quoted in Dormandy, The Worst of Evils, 104.

  “Pain never comes where it can serve no good purpose”: Quoted in Bending, Representation of Bodily Pain, 65. For further discussion of the split between science and religion, see Bending, 5–81.

  III. TERRIBLE ALCHEMY: PAIN AS DISEASE

  there are only 2,500: See Brenda Bauer et al., “U.S. Board Certified Pain Physician Practices: Uniformity and Census Data of Their Locations,” The Journal of Pain 8 (March 2007): 244–50.

  just 5 percent of chronic pain patients: See Roxanne Nelson, “Few Chronic Pain Patients See a Specialist,” Internal Medicine News, October 1, 2006.

  first comprehensive textbook: Bonica’s first edition was published in 1953, but it has subsequently been revised and updated twice. See John David Loeser, John J. Bonica et al., Bonica’s Management of Pain (Philadelphia: Lippincott Williams & Wilkins, 2001).

  a $1.5 million judgment: The case is Bergman v. Chin. For a good summary, see Bruce David White, Drugs, Ethics and Quality of Life (Binghamton, N.Y.: Haworth Press, 2007), 115–18.

  “If for some disease a great many different remedies are proposed”: See Anton Chekhov, The Cherry Orchard (New York: Samuel French), 18.
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  sleep poorly: In a survey by the National Sleep Foundation, two-thirds of chronic pain sufferers reported unrefreshing or poor sleep.

  symptoms of mental illness: See, for example, Emma Young, “Are Bad Sleeping Habits Driving Us Mad?” The New Scientist, February 18, 2009.

  deconditioning and guarding behavior: For a good review of the mechanisms by which pain syndromes can cause deconditioning, see “Disuse and Physical Disconditioning in Lower Back Pain” in Gordon J. G. Asmundson et al., Understanding and Treating Fear of Pain (New York: Oxford University Press, 2004).

  no specific diagnosis: See I. Abraham et al., “Lack of Evidence-Based Research for Idiopathic Low Back Pain: The Importance of a Specific Diagnosis,” Archives of Internal Medicine 162 (2002): 1442–44.

  up to 85 percent of such cases: Richard A. Deyo et al., “What Can the History and Physical Examination Tell Us About Low Back Pain?” Journal of the American Medical Association 268 (1992): 760–65.

  “Whatever pain achieves”: See Scarry, The Body in Pain, 4.

  “no words for the shiver and the headache”: See Virginia Woolf, “On Being Ill,” in Selected Essays (New York: Oxford University Press, 2008), 102.

  set by evolution at a relatively fixed point: For a good explanation of the nociceptive threshold, see Christine Brooks, Nursing Adults: The Practice of Caring (Philadelphia: Mosby, 2003), 112.

  a full one-third of damaged disks: O. L. Osti, “MRI and Discography of Annular Tears and Intervertebral Disk Degeneration: A Prospective Clinical Comparison,” Journal of Bone and Joint Surgery 74 (1992): 431–35.

  nearly half of patients: Cited in James M. Cox, Low Back Pain: Mechanism, Diagnosis and Treatment (Baltimore: Williams & Wilkins, 1998), 407.

  attached a small device to the base of subjects’ thumbnails: Drs. Clauw and Gracely presented this evidence at an October 2002 meeting of the American College of Rheumatology. They have published their findings in separate papers, including R. H. Gracely et al., “Functional Magnetic Resonance Imaging Evidence of Augmented Pain Processing in Fibromyalgia,” Arthritis & Rheumatism 46 (2002): 1333–43, and “Evidence of Augmented Central Pain Processing in Idiopathic Chronic Low Back Pain,” Arthritis & Rheumatism 50 (2004): 613–23.