"Pain is the most vivid experience we can never quite describe, returning us to the wordless misery of infancy."
-- Melanie Thernstrom, in The Pain Chronicles
by Ken
So you've had a great weekend, right? And you're just rarin' to get back to the workplace tomorrow for another week of stimulating and productive and of course generously compensated labor, right?
What better time could there be for some seriously jolly chat about pain?
I think it's a subject that's likely to be of interest to just about everybody, and when two people with both serious interest and serious credentials have a conversation about it, there's a good chance that interesting things are going to be said, which I think is the case with the conversation presented to us by The American Prospect, whose interest was drawn by the extension of the subject of pain into the political zone. So the piece comes to us under the title "The Politics of Pain," edited and presented by Amelia Thomson-DeVeaux.
I'm going to leave it to her to introduce us to the participants, as she introduces the edited version of the dialogue.
In the spring of 1992, as the contentious Democratic primary ground to a close, Bill Clinton was speaking at a rally in New York City when an AIDS activist accused him of ignoring the ongoing HIV epidemic. Uttering four words that epitomized his campaign style, Clinton told the activist, “I feel your pain.”I'm going to leave it to you to decide how much you want to pursue this conversation, which I confess both intrigues me and leaves me unsatisfied. Officially both participants seem to be talking about physical pain, but in the discussion what I'm hearing seems to intermingle indiscriminately physical and emotional pain, which I expect the experts would tell us have similarities and differences, but those similarities and differences constantly leave me feeling that once the discussion veers into the political sphere, I'm not really confident that it really means what the speakers think it does.
Clinton’s remark was widely mocked by conservatives who believed that bleeding-heart liberal policy, under the pretext of compassion, was creating a culture of dependence. In his new book, Pain: A Political History, Keith Wailoo argues that over the past 60 years, sparring over what constitutes pain, who can judge pain, and how the government should mete out treatment has elevated our maladies into fraught political concerns. Pain resists measurement, raising questions about whether sufferers can be trusted to evaluate their own distress. Conservatives worry that chronic pain is a symbol of underlying social maladjustment, while liberals seek to put the means of relief into patients’ hands. Should pain count as a disability? Does relief encourage fraud and addiction? Wailoo, the Townsend Martin Professor of History and Public Affairs at Princeton University, contends that the politics of pain has morphed beyond rhetoric into an enduring partisan divide.
In 2010, Melanie Thernstrom wrote about physical suffering in The Pain Chronicles, a book that is simultaneously a memoir of her own experience of chronic pain, an exploration of the scientific foundations of pain, and an expansive record of pain’s cultural meanings. She explores the paradox of pain: Impossible to articulate, it is a defining and unifying element of humanity. “Pain is the most vivid experience we can never quite describe, returning us to the wordless misery of infancy,” she writes. Whose pain is real—and whose pain can be cured—are questions that have reverberated for generations.
Wailoo and Thernstrom’s exchange has been edited for concision and clarity.
That said, I thought you might be interested in two samples that are clearly of interest to anyone engaged in current-day politics.
FIRST WE HAVE AN OVERVIEW OF THE WAY
PAIN MAY BE REFLECTED IN POLITICAL VIEWS
MELANIE THERNSTROM: Your book traces the evolving politics of pain, suffering, and disability—how we as a society evaluate people’s pain, whether it’s real and worthy of treatment and social support, beginning with the story of wounded veterans from World War II. How do we think about pain in a political sense? What is the “liberal” or “conservative” attitude toward pain?KEITH WAILOO: You can begin to understand that divide through caricatures that have developed over the years. Liberals believe in compassion toward others—they believe that subjective claims about pain ought to be taken seriously and endorse broad-minded approaches to relief. Conservatives believe in stoic, grin-and-bear-it approaches to pain. They believe people should push through pain despite discomfort in order to get back to work. They also tend to critique this bleeding-heart, overly compassion--oriented society as lacking objective criteria for judging the pain of others, which leads society in a terrible direction of increasing dependency and welfare. To some extent, these caricatures hold up. Liberal eras like the 1960s and 1970s did produce innovations like patient--controlled analgesics, which essentially said, regardless of whether you believe a patient is in pain, just hand them a morphine drip and have them determine what level of relief they deserve. But then sometimes they don’t. You have President Dwight Eisenhower, who’s a Republican and signs the first disability act within Social Security in 1956. Or you have President Jimmy Carter’s attempts to roll back the growth of disability benefits.
NOW WE HAVE THE INTERESTING QUESTION OF
HOW THE POLITICS OF ABORTION FIT IN, OR DON'T
MELANIE THERNSTROM: One interesting reversal from the stereotypes—that liberals are compassionate and conservatives aren’t—that you write about in the book is the conservative notion that a fetus can feel pain during an abortion. It’s hard to believe that this position can get anywhere, because there’s a strong scientific consensus that a fetus doesn’t experience pain in the way that people do. The parts of the brain like the limbic system that allow humans and other higher mammals to generate an experience of pain and suffering haven’t developed in a fetus.
KEITH WAILOO: So much of the discourse surrounding pain has limited scientific foundation, and the question of fetal pain is one of the best contemporary examples. That contention—that the fetus feels pain—is extraordinarily politically powerful. In conservative religious states, part of the effort to roll back access to abortion involves these requirements that women be told that the fetus can feel pain before they can proceed with the abortion. In the book, I explain where the idea of fetal pain originated. It goes back to the Reagan years. A film released in 1984 called The Silent Scream argued that the fetus screams—and feels pain—during an abortion. It’s that political contention that drives the fetal-pain debate. Certainly based on what we know about fetal development, neurological development, and the physiology of pain, there is no scientific basis for this claim. But little of this cultural politics of pain revolves around actual science. Here was a president who was being bashed by liberals for ignoring people in pain, and this allowed him to say that he did feel compassion for a particular class of “person” and a particular kind of pain. It became an important and effective political argument regardless of the scientific underpinnings.
I GUESS WHAT I KEEP THINKING HERE --
is that while the subject seems to be attitudes toward pain, it maybe would rather be about other things, things which drive those attitudes. Note, for example, that the "reversal from the stereotypes" reflected in the opposite liberal-conservative application of pain attitudes to abortion is strikingly similar to the reversal that's reflected in attitudes toward "life." Just as the only pain that seems to interest conservatives is fetal pain, the only "sanctity of life" they seem to revere is the fetal kind. Once the child is born, neither its life nor its pain seems to be of interest to the right-wing holier-than-thous.
It remains a fascinating subject, or subjects, this business of pain and suffering, and it's one that doesn't get talked about much. We have to start somewhere, and both of these authors clearly have a great deal to say about the subject, which might be interesting to explore in their own presentations.
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