How can I explain personal pain?

Describing pain is a notoriously tricky task. Plenty of work has been done over the years to try to measure what people feel. There are numbers to choose from, there are faces that start smiley and show increasing amounts of distress. There was a man who let himself get stung over and over and over again, trying to come up with a truly objective pain scale. Still, in spite of all this work, there’s no tool that lets a doctor really, truly know what her patient is experiencing. It’s still possible, therefore, for a doctor to listen to a person talk about suffering and choose not to believe her. The Violent Femmes lamented this conundrum, asking “how can I explain personal pain?/How can I explain, my voice is in vain?” Surely this is a refrain that many a patient can relate to.

A recent article in the New Yorker gives hope that this problem may finally have a solution. Researchers are using something called a 7-Tesla MRI to scan the brain as they induce varying levels of pain in their subjects. They have been able to see that different people respond differently to the stimuli. They’ve learned, strangely, that redheads react to pain sensations in reliably odd ways. More significantly, they’ve been investigating the brains of chronic pain patients and have shown that, in some people, “the mechanism that exacerbates pain is dominant”. At long last this is a way of looking objectively at people’s pain. With this machine a person’s suffering is visible, even if all other scans show that there’s nothing wrong and there should be no symptoms. This technology could lead to the end of bias, not to mention just plain confusion, in the treatment of pain.

Unfortunately, widespread implementation is a way off. The New Yorker piece was written from a laboratory in a university. There are only a few hundred 7-Tesla MRI machines in existence and they are, of course, ridiculously expensive. For the foreseeable future, people are still going to have to keep trying to explain their pain. Here at Pain Free Clinic we would like to offer one small comfort in the confusion of pain reporting and treatment: We believe you. As David Foster Wallace wrote in Infinite Jest, “You are welcome regardless of severity. Severity is in the eye of the sufferer…Pain is pain.”