Pain Is Inevitable, Suffering Optional
An inevitable part of the human experience, pain is impossible to objectively measure, but felt universally. While artists have forever represented pain, it is something most must endure alone.
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Pain is both a universal and a deeply isolating experience.
It is perplexingly difficult to convey
a precise description of it to another person.
Yes, we call it hurt, ache, or even agony,
but for something so ubiquitous,
our vocabulary for discussing it is remarkably basic.
Over the years, doctors have developed strategies
for helping patients express their pain.
They might ask us to point out the face of our pain
on a chart or rank it on a scale of one to 10,
but these measurements are ultimately just as personal
as the pain itself.
- If I'm at a seven or if I'm at a five,
that would be someone else's like, oh my God, take me now.
I can't live any longer, you know?
- I'm a total wimp.
I took all the drugs, you know,
as much as I could for my three childbirths.
Absolutely. I was on that side of things.
- I mean, pain is such a personal experience, you know?
So in our pursuit to try and have other people
understand what we're experiencing, there is a compulsion
to want to compare it to something else,
but the effectiveness of that
is kind of debatable as well, you know?
No one knows what it feels like when you broke your arm,
you know, however many years ago.
- [Jim] Since time immemorial,
art has been the ally of subjectivity.
Capable of expressing the ephemeral:
love, beauty, and yes, even pain.
In 1611, Peter Paul Rubens illustrated the pain
of Prometheus, eternally bound to a rock
and condemned by Zeus, the king of the gods
to have his ever regenerating liver picked upon daily
by an eagle as a punishment
for giving humanity the gift of fire.
In 1873, Gustave Courbet depicted a trout
hooked and bleeding from its gills
as a representation of the agony he was suffering
with alcohol induced liver failure.
And in the early 20th century, Frida Kahlo
expressed her experiences of chronic pain
after a road accident left her
with a fractured spine and pelvis.
And so as photographer Justin Wee also discovered
through suffering chronic back pain,
when words fail, images can prevail.
- I visualize pain.
If you would ask me to describe an ulcer,
I would immediately think of something
that was like very craterous and very treacherous,
like the surface of the moon and like a golf ball,
it's the entryway into those crevices
that feel so treacherous, you know,
when you have an ulcer on your tongue
and like you get a zip of lemon or something.
That lemon enters the crevice of your ulcer
and just kills you, you know!
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- Seeing, hearing, tasting, smelling, you know,
these are perceptions that our brain constructs
and pain is one of those perceptions.
And so it's something that's yours.
It's how your brain constructs it
in the context in which you're experiencing it
and your particular mood and your cognitive state.
So it will always be this subjective private thing.
(inquisitive piano music) - [Jim] Irene Tracey
is the Director of Oxford University's
Nuffield Department of Clinical Neurosciences.
She spent the better part of the past two decades
earning her nickname, "The Queen of Pain"
by examining the myriad factors
that impact what pain means to each of us.
- I think what people sort of fail to remember
is that when you're developing to adulthood,
your central nervous system, you know,
your spinal cord and your brain,
that's putting together all these experiences
that we perceive and feel, you know,
that's been wired up, that's been developed,
your brain is developing, it's folding,
it's forming new connections,
so, you know, as an adult, you end up with a brain
that's you know, really a product of that nurture
as well as the nature.
And I think we're only scratching at the surface now
with our brain imaging tools
and this is more broadly in neuroscience,
not just pain, just how important that life's journey is
on the type of brain you end up with.
In neuroscience and particularly in pain, you know,
I think we're recognizing just how important now that is.
(lively violin music) - [Jim] And because pain
is so formative to a person's character,
yet so internalized,
it took Justin Wee a long time to understand
that he was surrounded by people in pain.
- I was just having a lot of conversations
with my friends about, you know, the various types of pain
that we were going through and it was very jarring to me
because, you know, we all look to our friends as,
you know, superheroes in our lives
and I was baffled by the amount of pain
that my friends were in.
- [Jim] And so in the hope
of finding a better understanding, he asked these friends,
all of whom are gifted visual storytellers,
to interrogate their own interactions
with the sensations and effects of pain.
- So I put out a call out on my Instagram.
One of the things that I asked them was
if there was a color that you would attach your pain to,
what would it be?
if there was any sort of visual depiction
of what your pain looks like, what would it be?
What do you do when you experience the pain?
And what do you do right after you experienced the pain?
Because pain is not just about the moment
and the incident of it, it is about how
you build your life around it as well
and I really wanted the still lifes
to not just be like a general representation of pain,
but I wanted them to be a very specific representation
of someone's pain, you know, because pain is so personal.
When I started the project, I was like, okay, cool,
I'm going to do my own image on my own back pain
and that's going to be mine.
And then my friend DMed me and she was like,
oh, I also live with chronic back pain.
And so I asked her to fill out the survey
and the way that she described her back pain
was so visceral and so, I mean,
the language used was so stunning
that I ended up using her words to create the image.
And what I loved most about her particular experience
was that I could never have articulated my back pain
in the way that she articulated hers,
but it was so deeply resonant.
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- [Jim] Author Ruthie Lindsey has survived
a great deal of suffering in the past 25 years.
At age 17, she was involved in a car accident
that left her with a broken neck, punctured lungs,
and a ruptured spleen.
After a spinal cord fusion, she was miraculously able
to walk out of the hospital less than a month later.
But a few years later, Lindsay found herself
riddled with mysterious chronic pain
and reliant on painkillers.
She documents her experiences in a memoir called,
"There I Am: The Journey From Hopelessness to Healing"
published by Simon and Schuster in 2020.
- I was a shadow of myself.
I could not experience goodness.
Everything was dimmed.
Like I didn't notice flowers.
I didn't notice sunset.
I didn't notice my partner, my friends, my family.
I mean, my nieces and nephews were born in that seven years.
I didn't see them.
- I know you had a spiritual upbringing.
Did you have to unlearn the idea that pain is necessary
for redemption or did that ever enter your head?
- There's a lot of things that I've had to unlearn.
I was a part of a church that said
I was a broken depraved wretch,
I believed it with every part of me.
I thought I was, something was fundamentally wrong with me.
I was taught original sin, which there's no,
those words are never in the Bible,
and you know, because of that,
I thought I was broken.
Something outside of me needs to come and fix me.
- [Jim] And there are many more recent examples
of artists and musicians exploring suffering
through their work.
Kurt Cobain, the leader of the hugely popular 1990s
grunge rock band, Nirvana,
suffered chronic undiagnosable stomach pain.
When conventional medicine failed,
he sought relief in illicit drugs.
A heroin addiction would eventually lead him
to take his own life at age 27.
♪ Things have never been so swell ♪
♪ I have never failed to fail
♪ Pain And so for a lot of artists,
their work has alleviated at least some of their suffering.
This wouldn't surprise Irene Tracy
as she has continued to discover through her research
much of our physical experience of pain
is determined in part by what's going on in our brains.
- You know, if pain is physically generated
through a physical injury, we, again,
society was slightly more comfortable with that
and there is a bias towards that,
well, that's real pain, and then this other one
that's more generated by brain networks without an input
is sort of second class and isn't really serious
and I'm written very emphatically on this
that that is not correct.
You know, pain is pain.
It is a brain based experience.
It is produced by networks of brain regions coming together
and I don't care whether your pain
has been generated by brain networks
or been induced from inputs.
It doesn't matter.
It's important to know, because then you know
where to target to switch it off, but pain is pain,
and therefore it should be the both.
They're not first or second class.
They're both first-class pains.
We've got to deal with them as equal.
- [Jim] But if pain is pain, then is that which is caused
by emotional distress rather than physical injury
the same thing?
Irene Tracy says that science is not yet ready
to answer this question.
- So some of the experiments that have been done
by other great colleagues and teams,
notably in the US, has been to look at say,
let's look at the say, emotional pain side
and the non-physically induced pains,
where they will look at how does the brain activate
when it's in an emotionally pain state,
because you've induced a sense of being socially excluded,
or you've looked at the brain pattern as I'm saying,
looking at somebody, being stabbed with a thing,
and I'm like having an empathic reaction towards that.
And what you find is that whilst there really are
a very important differences in certain brain regions
that are not active that you would expect to see active
to if I just stabbed you with a knife,
there's an awful lot of overlap too,
and the overlap tends to be in those areas of the brain,
the more emotional parts of where the brain reacts
to the emotional side of pain.
So there's this interesting overlap, but difference too
and those experiments are still continuing
and refining our understanding of the extent
of that overlap and that separation.
- [Jim] Recognizing the neurological link
between the physical and emotional aspects
of pain might also help us to understand the role
that creative expression has to play
in shaping our subjective experiences of pain.
- We're entitled to feel our hurt and our frustration,
our sadness at the ways that our bodies are changing,
our sadness at the things that, you know,
have happened to us that have caused us this pain,
and, you know, we should make space
to feel those things, you know?
- If you experience the beauty, you have to allow yourself
to feel and experience the pain and trauma
and it is, it's brutal.
But it's also, that is a full, whole-hearted life.
- [Jim] And so, as our understanding of pain expands,
art may be a useful ally helping us to process our hurt
but also offering the possibility
that we might connect with one another in the open,
engaging our pain fully, rather than hiding it away.
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- [Narrator] "Articulate with Jim Cotter" is made possible
with generous funding from the Neubauer Family Foundation.