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New Book On Pain: Eye Opening Perspective From A Patient
Review | ‘The Pain Chronicles’: Pain and suffering stalk the unlucky
The author, afflicted with degenerative disease, delivers a staggering amount of information.
BY SUSAN MIRON
THE PAIN CHRONICLES: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering. Melanie Thernstrom. Farrar, Straus and Giroux. 368 pages. $27.
As the title indicates, Melanie Thernstrom’s landmark book is a near-encyclopedic coverage of pain. But it’s also the author’s tale of her 12-year physical struggle, a personal connection that makes this informative book deeply affecting.
The Pain Chronicles began nine years ago when Thernstrom, who was diagnosed with spinal stenosis, cervical spondylosis and other degenerative conditions in her early 30s, was working on an article for The New York Times. After visiting clinics and observing doctors with their patients, she wanted to know — as a sufferer and a journalist — why some people got better, and others didn’t.
Chronic pain afflicts more than 70 million Americans, and every word of Thernstrom’s investigations into this mysterious subject rings true. Pain, she writes is “a specter in our time: a serious, widespread, misunderstood, misdiagnosed, and undertreated disease.”
Author of Halfway Heaven: Diary of a Harvard Murder, Thernstrom deftly delivers the staggering wealth of her complex findings and thoughts in short, almost haiku-like chapters. She launches her attack on page 3: “To be in pain is to find yourself in a different realm — a state of being unlike any other . . . What of the pain that persists? The longer it endures, the more excruciating the exile becomes. Will you ever go home? you begin to wonder, home to your normal body, thoughts, life?”
Chronic pain, Thernstrom writes, is more than a six-month bout of suffering; it is the inability of the body to restore normal functioning. Untreated pain, she explains, can eventually rewrite the central nervous system, causing pathological changes to the brain and spinal cord that in turn cause greater pain.
Thernstrom discusses pain as metaphor, history, disease, narrative and perception. She weaves excerpts of her diary through the academic writing, which holds a wealth of information. Her findings are as upsetting as they are morbidly fascinating. For example, estimates reveal that between one-third and one-half of people who suffer from chronic pain also have a major depressive disorder. “Pain causes depression just as reliably as difficulty breathing triggers panic,” she writes.
The chapter on the history of “surgical sleep” describes gruesome surgeries before anesthesia when operations presented “a terror that surpassed all description.” Experts believe the development of anesthesia resulted from cultural changes in the late 18th and early 19th centuries that simply demanded the abolition of pain. Anesthesia was hailed as “the wonderful dream that pain has been taken away from us.” The puzzle remains about why it wasn’t practiced earlier.
One of the challenges of those with chronic pain is explaining their suffering to others. Thernstrom writes that part of the curse of pain “is that it sounds untrue to people who don’t have pain.” She quotes Elaine Scarry: “Whatever pain achieves, it achieves in part through its unsharability.” Thernstrom writes unabashedly of beginning to feel jealous of all those who didn’t have pain. And who can blame her?
In the chapter “The Martyr’s Paradox,” she writes about being offended by the perversity of the idea of pain’s being spiritually transformative. “Pain is useless to the pained. If we try to describe the particular terror of pain, it seems to lie in the way that it kidnaps consciousness, annihilating the ordinary self.”
Thernstrom writes evocatively about pain in history, art, religion and literature, but when she focuses on people and how pain has reshaped and warped their lives and senses of self she writes with fervor. “Do you think I’ll get better? is the only question on every patient’s mind.” The patients she writes of so memorably are alternately brave, emotionally defeated — and angry enough to see 85 different doctors. There are few perfect outcomes, even with the help of alternative medicine and physical therapy. “Pain,” Thernstrom writes simply, “brings out the best or worst in people. . . . We write about pain, but pain rewrites us.”
Susan Miron is a writer in Massachusetts.
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