Pain: The Science and Culture of Why We Hurt

Abstract

Although you may be tempted to read only a few chapters of this book initially, after those few, you will want to read more. This book is well written and easy to follow. It has the feel of a good novel but is full of insights into why we hurt, what it is like to hurt, and how we deal with it (or not). In the first chapter, we learn why the author was driven to study this topic (her own personal injury causing introspection and journalistic skills to run wild). Other chapters include the history of pain and ways pain is treated according to a comprehensive list of approaches. The book provides a readable and comprehensive explanation of a convoluted topic. The journalist author uses her skills to uncover every aspect of pain, leaving no page unturned and no corner unexplored. From her journalist perspective, she does her homework. This is not a textbook or a research paper, just the result of one lay individual's curiosity and desire to know more. The fact that the author is a journalist by trade means that the writing is both factual and fluent. Throughout the book, Marni Jackson covers topics such as mental versus physical pain, malingering, and the relationship of pain to disease. As in a novel or a documentary, key characters appear, such as Melzack and Wall. This book is packed with “case studies” of individuals with pain and their adventures through the medical system—what worked, what failed to work, how they understood their experience, and how the system works. Helpful insights from the book include Jackson's explanation of the role of psychiatry and pain (“it helps one get intimate with pain”), the role that self-judgment plays in compounding pain, and an explanation of phantom pain as evidence that pain can be all in your head and represents a perceptual illusion in which vision, body image, and memory come together. There is a short but meaningful chapter for anyone who has had intense pain: “Citizens of Four AM.” Suffering from nerve pain makes one appreciate this title. The hour may vary, but the thoughts, fears, and feelings shared in this chapter can be the same. As physiotherapists, we may spend time helping the person in pain deal with this hour of the night when they are in intense pain. It is here that despair and hopelessness can set in! This chapter is a good reflection of what occurs and, as a result, may help us empathize with those who suffer. Another enjoyable chapter is titled “Taking the Suffering Out of Pain.” The discussion on meditation, Buddhism, and how to embrace pain instead of running from it is well presented and provides a helpful perspective on dealing with chronic pain. It may challenge some health care professionals to explore this avenue in order to better serve their patients. Overall, the book illustrates well the connections among the physical, emotional, and spiritual well-being and how treating only one may be unsuccessful. What I found least enjoyable about this book was the section on masochists. This section is not helpful in understanding pain but perhaps was important to the author in covering the scope of possible ways in which pain can present. There are also some areas that are dealt with in a negative way, such as patients’ experience with the Workplace Safety and Insurance Board (WSIB). Those who are caught in the WSIB system may experience some anxiety as they read this section. As physiotherapists, we may find this book helpful in providing another perspective on pain. While there may be no new theories or treatments provided, there is a depth of writing and journalistic work that makes it an important contribution to the study of pain. This book may also be helpful to recommend to patients who are dealing with challenges in coping with pain. A selected bibliography at the end lists books, articles, and papers used by the author that may be useful for further reading on the subject. The reader is left feeling that pain is complex, that there is no easy way to treat it, that we are on a journey, and that pain “is not always conquerable but it is adaptable”—that it is better to work with it than against it. This book is recommended for people who are in pain and for their health care professionals.