Somatic pain

On Tuesday an MRI showed a mass on Laura’s brain.  On Wednesday I spent the day making phone calls to get an appointment with the brain surgeon who had been recommended by Laura’s doctor.  On Thursday morning we drove into the city to meet with the surgeon.  By early Thursday afternoon, Laura was in a bed in the neurosurgery unit waiting for an MRI and CT scan to prepare for a craniotomy and biopsy the next morning.  In order to map Laura’s brain for surgery, they had to do the CT scan with contrast, which meant injecting iodine into Laura’s bloodstream through a port in her arm.  The nurse assigned to Laura tried twice to insert the needle into Laura’s vein without success, but with lots of pain.  Laura winced but did not cry or cry out.  Hospital protocol required that after two attempts another nurse be called in.  I wasn’t so sure about the second one’s youth, punk hair-do, or piercings, but she was very competent and mercifully quick.

Many nerve receptors lie close together in the skin and underlying tissues. When they are stimulated, energy changes into electrical impulses that are transmitted and modulated by the nervous system.  What we call “pain” is our experience of that process.  (Ransom et al. 249; Gatchel et al. 1)

This paraphrase of a “scientific” definition of pain uses verbs like “stimulate,” “change,” and “transmit” to emphasize activity and movement.  The textbook uses the nouns “transduction, transmission, and modulation,” lumps these together under a new noun, “nociception,” and claims that this is the “objective” phenomenon, something that’s happening in our body on which we construct the “subjective” phenomenon, the more amorphous thing, we call “pain.” Even in a paraphrase that uses more verbs, we still use nouns like “pain,” “experience,” “process,” “energy,” and “impulse” as if we were talking about substantive things.

Hadjistavropoulos and Craig do a little better by calling nociception “physiological” and pain “psychological.”  We’ll get back to the problems that arise from dividing mind and body.

In her book The Body in Pain, Elaine Scarry uses the preposition “against” to define pain as:

a pure physical experience of negation, an immediate sensory rendering of ‘against,’ of something being against one, and of something one must be against.  Even though it occurs within oneself, it is at once identified as ‘not oneself,’ ‘not me,’ as something so alien that it must right now be gotten rid of. (52)

But Scarry still frames this insight with nouns and pronouns, saying that “oneself” experiences “negation” by “something.”  In these presentations, however, we will work on talking in terms of verbs, adverbs, prepositions, and interjections, words like “ to sense,” “to feel,” “to hurt,” “against,” “not,” more than in terms of nouns, pronouns or adjectives, words like “negation,” “something,” “oneself,” “me,” “it.”

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