Pain and Context

I just finished reading an awesome article on pain.  No, it wasn’t on how to inflict pain (there are lots of articles on that) it was about the imprecision around the treatment of pain.

One of the first things that struck me was the imprecision of pain.  “One a scale of 1 to 10, how does it feel?”  How are you supposed to know what a 10 is?  For women who have given birth the doctor will say, “assume that childbirth was a 10”, but it’s not always that simple.  The author of the article talks about his wife who had pancreatitis and woke up with a pain that “made her howl like a tortured witch facedown on a bonfire.”  I have some personal experience with pancreatitis so I can picture a 10 on the pain scale and, yeah, the description feels quite appropriate.

But is pain as simple as that?  As simple as a number from 1 to 10?  The Nuffield Professor of Anaesthetic Science, Professor Irene Tracey (the Queen of Pain), says that for people who have not given birth “Imagine you’ve slammed your hand in a car door – that’s 10.”  I’ve done that as well.  It was nowhere near the level of pain I experienced with pancreatitis.  Hand in a car door?  That’s a seven, maybe an eight.

So when someone says “how bad does it hurt” and then gives you a scale of 1 to 10, it’s pretty hard to come up with an appropriate answer.  When you are experiencing the most pain you have experienced, it is a 10.  But when you’ve experienced something more painful it might only be a six.  The other person, not having your experience (stubbed toe is the highlight of their pain) may think that a six is okay and that the pain is not that bad.  But it is.

Context (experience) is everything.

Without context, we can’t accurately understand each other as human beings.  Racism, hatred, all the dark emotions and even the lighter ones, love and joy, all require some context.  When you’ve experienced one extreme that opens up your perception to the other extreme.  When you’ve experience hatred, love seems so much more exciting and wonderful.  When you’ve experienced a deep, personal loss, then joyous moments brighten up your day so much more than before.  The more you love someone the more abhorrent hatred of any type seems.

Context is how the same word can mean polar opposites when said by two different people.  Context is how we understand the pain that someone is going through.  Context is what we need to have when we are solving problems, or the problem we are solving may be the wrong problem.

“Your pain is a six?  That’s ibuprofen time.” OR “Your pain is a six? Considering the pain you’ve had in the past that sounds like appendicitis.”

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