The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the…

Paperback | August 2, 2011

byMelanie Thernstrom

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In The Pain Chronicles, Melanie Thernstrom traces conceptions of pain throughout the ages-from ancient Babylonian pain-banishing spells to modern brain imaging-to reveal the elusive, mysterious nature of pain itself. Interweaving first-person reflections on her own battle with chronic pain, incisive reportage from leading pain clinics and medical research, and insights from a wide range of disciplines, Thernstrom shows that when dealing with pain we are neither as advanced as we imagine nor as helpless as we may fear.

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In The Pain Chronicles, Melanie Thernstrom traces conceptions of pain throughout the ages-from ancient Babylonian pain-banishing spells to modern brain imaging-to reveal the elusive, mysterious nature of pain itself. Interweaving first-person reflections on her own battle with chronic pain, incisive reportage from leading pain clinics ...

Melanie Thernstrom is a contributing writer to The New York Times Magazine and the author of The Dead Girl and Halfway Heaven: Diary of a Harvard Murder.

other books by Melanie Thernstrom

Halfway Heaven: Diary Of A Harvard Murder
Halfway Heaven: Diary Of A Harvard Murder

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The Dead Girl
The Dead Girl

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Format:PaperbackDimensions:432 pages, 8.25 × 5.5 × 0.96 inPublished:August 2, 2011Publisher:PicadorLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0312573073

ISBN - 13:9780312573072

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ITHE VALE OF PAIN, THE VEIL OF PAIN:Pain as MetaphorDOLOR DICTATMortals have not yet come into ownership of their own nature. Death withdraws into the enigmatic. The mystery of pain remains veiled,” the German philosopher Martin Heidegger writes. Does metaphor unveil pain to reveal its true nature, or is metaphor the veil that surrounds pain—and makes it so hard for us to see pain as it is?Pain is necessarily veiled, David B. Morris writes in The Culture of Pain, because, to a physician, pain is a puzzle, but to a patient it is a mystery, in the ancient sense of the word—a truth necessarily closed off from full understanding, which refuses to yield every quantum of its darkness: “a landscape where nothing looks entirely familiar and where even the familiar takes on an uncanny strangeness.”But “illness is not a metaphor,” Susan Sontag sharply asserts in Illness as Metaphor. “The most truthful way of regarding illness—and the healthiest way of being ill—is one most purified of, and resistant to, metaphoric thinking. Yet,” she complains, “it is hardly possible to take up one’s residence in the kingdom of the ill unprejudiced by the lurid metaphors with which it has been landscaped.”How true this sounds! I read it again and again to feel its full weight—how helpful and clarifying it is. Sontag’s point seems to turn on what one might think of as the different resonances of the words illness and disease. While disease refers to biological pathology, illness opens the door to a world of wider meanings—the very meanings, Sontag says, that burden and confuse the patient. When the pathology of the illness is finally understood, metaphors will fade away, she asserts, in the way that consumption became TB. Cancer is not an expression of repression, it is a cluster of abnormally dividing and enduring cells; AIDS is not retribution for homosexuality, it is an immune deficiency. Pain is not a pen dipped in blood, scribbling on the body in illegible script, nor is it a mystery to be divined; it is a biological process, the product of a healthy nervous system in the case of acute pain and a diseased one in that of chronic pain.True, true. Yet even when pain is understood this way, its metaphors endure. When pain persists, a biological disease becomes a personal illness. The illness changes the person, and the changed person reinterprets the illness in the context of her life, experience, personality, and temperament. A thousand associations spring to mind—personal, situational, cultural, and historical.As soon as we reject certain metaphors, others immediately take their place. Foucault’s modern doctor may ask, “Where does it hurt?” but the patient will ceaselessly—idly and intently, consciously and unconsciously—contemplate the old question, “What is the matter with me?” and this wrongness cannot be illuminated by the word pain.More, perhaps, than any other illness, protracted pain spawns metaphor. As has oft en been observed, pain never simply “hurts.” It insults, puzzles, disturbs, dislocates, devastates. It demands interpretation yet makes nonsense of the answers. Persistent pain has the opaque cruelty of a torturer who seems to taunt us toward imagining there is an answer that would stop the next blow. But whatever we come up with does not suffice. We are left like Job, bowing before the whirlwind.On one hand, nothing is more purely corporeal than physical pain. It is pure sensation. Indeed, it oft en figures in literature as a symbol of illegibility and emptiness. As Elaine Scarry writes in The Body in Pain, pain is uniquely lacking in a so-called objective correlative—an object in the external world to match with and link to our internal state. We tend to “have feelings for somebody or something, that love is love of x, fear is fear of y…,” she explains, but “physical pain—unlike any other state of consciousness—has no referential content. It is not of or for anything.”As Emily Dickinson puts it, “Pain has an element of blank.” Yet it is the very blankness of pain—the lack of anything it is truly like or about—that cries out for metaphor, the way a blank chalkboard invites scribbling. As soon as Dickinson tries to describe this great blank, she grasps for metaphor:Pain—has an Element of Blank—It cannot recollectWhen it begun—or if there wereA day when it was not—It has no Future—but itself—Its Infinite containIts Past—enlightened to perceiveNew Periods—of Pain.You try to wake yourself out of pain—it’s not an infinite realm, it’s a neurological disease—but you can’t. You are in a dreamscape that is familiar yet horribly altered, one in which you are yourself—but not. You want to return to your real self—life and body—but the dream goes on and on. You tell yourself it’s only a nightmare—a product of not-yet-fully-understood brain chemistry. But to be in pain is to be unable to awaken: the veil of pain through which you cannot see, the vale of pain in which you have lost your way.To be in pain is to be alone, to imagine that no one else can imagine the world you inhabit. Yet the world of pain is one that all humans must, at times, inhabit, and their representations of it pierce us through the ages. “Head pain has surged up upon me from the breast of hell,” laments a Babylonian in a story three millennia old. The agony of the ancient sculpture of the Trojan priest Laocoön and his sons as they are strangled by sea serpents still contorts the ancient marble, as does the very different agony of Jesus’ crucifixion in Matthias Grünewald’s Renaissance altarpiece.Dolor dictat, the Romans said—pain dictates, dominates, commands. Pain erases and effaces. We try to write our way out of its dominion. How savage its practices, how dark its vales! we exclaim, this unhappy country on whose shores we have washed up after a voyage upon which we never sought to embark.“I would have made a fine explorer in Central Africa,” the nineteenth-century French novelist Alphonse Daudet writes in his slim volume of notes about suffering from the pain of syphilis, published as In the Land of Pain after his death. “I’ve got the sunken ribs, the eternally tightened belt, the rift s of pain, and I’ve lost forever the taste for food,” he laments.If only Daudet were in Africa, instead of in Pain, he would know that one day he could return home and leave his tribulations behind. His scribblings might then seem to be tall tales: Was he really pricked with a thousand arrow points while his feet were held in fire? But if others were skeptical, he wouldn’t mind. He’d no longer need anyone to walk in that lonely place with him. Indeed, he would hardly recall it himself.But Pain is not a place easily left behind. We inhabit Pain. Pain inhabits us.Dolor dictat.We write about pain, but pain rewrites us. Excerpted from The Pain Chronicles by Melanie Thernstrom.Copyright © 2010 by Melanie Thernstrom.Published in 2010 by Farrar, Straus and Giroux.All rights reserved. This work is protected under copyright laws and reproduction is strictly prohibited. Permission to reproduce the material in any manner or medium must be secured from the Publisher.

Editorial Reviews

"Profound and engrossing, this exploration of pain is a pleasure." -People"If you are one of the more than seventy million Americans who suffer from chronic hurt, The Pain Chronicles could very well be the first time you hear from someone who speaks your language." -Time"[A] landmark book.deeply affecting.every word of Thernstrom's investigations into this mysterious subject rings true." -The Miami Herald"Dense with insight and elegant in style.Thernstrom's study considers the mysteries of chronic pain from nearly every possible angle." -The New Yorker"[The Pain Chronicles] is an expansive, invigorating mix of medical reportage, history, memoir and cultural criticism . . . At other times she is a fiercely knowledgeable science writer, delivering case studies and research findings with a storyteller's verve . . . But The Pain Chronicles is no mere self-help manual. It's a sophisticated, elegantly compiled treatise--as wide-ranging, complex and defiant as pain itself." -Robin Romm, The New York Times Book Review"An ingenious mix of science, history, investigative journalism, and memoir." -Alec Solomita, The Boston Globe"A comprehensive and thoroughly engaging portrait of a force that all of us have experienced, but few of us truly understand." -Ryan Brown, Salon"There have been hundreds of books published in the last decades on pain and its management, but none that combine memoir, scholarly research and journalistic reportage in the way Ms. Thernstrom, the author of two previous books, does. A stellar example of literary nonfiction . . . You can become absorbed, as I was, in the fascinating struggle over the use of anesthesia (and, later, opiates) in 'Pain as History,' or play voyeur during absorbing clinical vignettes of 'Pain as Disease' . . . Melanie Thernstrom is such an engaging and intelligent writer that I remained intrigued with her investigation even as I disagreed with some of her reportorial choices." -Helen Epstein, The New York Times"The Pain Chronicles blends cutting edge research, cultural and medical history, and real people's stories to make sense of the suffering." -O, The Oprah Magazine"She covers vast swaths of history, culture, religion and science in short, accessible and beautifully sequenced chapters . . . This book offers an illuminating journey toward new vision and possible relief." -The Oregonian"Thernstrom's descriptions . . . give a voice to millions of people whose lives are blackened by something that no one else can see." -Lucy Odling-Smee, Nature"An exquisite, meticulous history of medicine's quest to alleviate pain . . . The personal chronicles lift this accomplished medical history to an astonishing record of courage and endurance . . . In these stories, there is a wealth of knowledge, wisdom, and hope for the rest of us." -Publishers Weekly (starred review)"An intriguing investigation of chronic pain that combines expert opinion, philosophy and history with the author's personal struggle . . . A rich melange of ideas and journalism." -Kirkus Reviews"The Pain Chronicles combines Melanie Thernstrom's talents for both medical journalism and memoir. Whether she is unpacking the cultural history of pain or elucidating scientific studies, her limitless curiosity will engage and enlighten readers. Rarely has a topic of such sadness been made so compulsively readable." -Arthur W. Frank, author of At the Will of the Body and The Wounded Storyteller"A book about pain has no right to be so pleasurable to read, but such is the depth of Melanie Thernstrom's intellect, curiosity, and compassion that The Pain Chronicles is indeed a joy. It's also a revelation, a fascinating guide through a subject we all know so well but, until now, didn't know quite how to think about." -Stephen J. Dubner, coauthor of Freakonomics and SuperFreakonomics"In this elegant, beautifully written book, Melanie Thernstrom trains her prodigious intellect on a subject at once utterly universal and deeply, poignantly personal. The Pain Chronicles is that rare hybrid: a meticulously researched and important work that is also a riveting page-turner. This is required reading for anyone who wants to understand an essential aspect of our humanity." -Dani Shapiro, author of Devotion: A Memoir"An extraordinary tour of an important but often overlooked world--that of pain. Poignant and beautifully written, Melanie Thernstrom's book weaves together history, literature, psychology, neuroscience, and a deeply moving personal story to create a marvelously wise and erudite work that can enlighten us all." -Robert Klitzman, M.D., Professor of Clinical Psychiatry, Columbia University, and author of When Doctors Become Patients"After going for a swim one day, Melanie Thernstrom emerged from the water with an ache in her neck and soon found herself plunging down a rabbit hole into the dark Wonderland known as chronic pain. Thernstrom takes us on a personal tour of this world, which has become a second home to her and millions of her fellow sufferers. Her superb book The Pain Chronicles is an essential resource for those similarly afflicted, their loved ones, and, indeed, anyone wanting to know more about the most primitive and powerful of all sensory experiences." -Frank T. Vertosick, Jr., M.D., FACS, author of Why We Hurt and When the Air Hits Your Brain"Rarely has a single book so intelligently illuminated a universal human experience. Melding science, literature, religion, memoir, and history, Melanie Thernstrom has created a masterpiece that reveals how we seek diverse dimensions of meaning to transcend suffering." -Jerome Groopman, M.D., Recanati Professor at Harvard Medical School and author of The Anatomy of Hope and How Doctors Think"The Pain Chronicles is scholarly, lyrical, and humane, and will give tremendous comfort to those who are in pain and those who hope to understand them." -Andrew Solomon, author of The Noonday Demon"Melanie Thernstrom conveys, indelibly, that pain is not pressed upon us; it's in us, it's intrinsic to our being. I find that insight, and this book, invaluable in helping me understand my pain and the world's woe." -David Shields, author of Reality Hunger and The Thing About Life Is That One Day You'll Be Dead"Chronic pain is the Wild West of medicine. In The Pain Chronicles, Melanie Thernstrom navigates this territory--its history, its evolution, and its always shifting frontiers--with keen intelligence and insight. She shares her own story in order to illuminate a narrative of pain that is becoming more and more a national narrative. Thernstrom never flinches in the face of a subject that is easily overlooked or judged by those for whom it is, ironically, too painful. This is stellar work." -Alice Sebold, author of The Lovely Bones and Lucky