Melanie Thernstrom, The Pain Chronicles.
New York: Farrar, Straus and Giroux, 2010.
$22 approx. on line
Reviewed by Ted Witham
One purpose of religious faith is to make meaning. Christians especially find it difficult to make sense of chronic pain. As Melanie Thernstrom explains in her entertaining Pain Chronicles (yes, entertaining!), acute pain is an excellent response to injury. Acute pain protects us. Chronic pain, like cancer cells that don’t know how to stop, serves no such purpose. It afflicts at least one person in ten and resists most treatments.
Christians need a strong theodicy to incorporate pain into their understanding of a loving God. In his 1993 memoir missionary doctor Paul Brand, famous for his work with leprosy, tried to sell the idea that pain is “the gift nobody wants.” Brand saw the lepers’ infected cuts and burns, injuries caused because they could not feel pain, and argued that we should praise God for the protective properties of pain. For Christians with chronic pain, this is not persuasive. Chronic pain serves no good purpose. As a chronic illness it challenges God’s ability to heal.
The Pain Chronicles tells two inter-twined stories: it is a memoir of Melanie Thernstrom’s own journey from her futile searching for cause and cure, to a more productive attempt to make sense of a life with ongoing pain. Formerly a staff writer with the New York Times, Thernstrom shares this journey with a robust honesty, especially her initial belief that her pain was a punishment for an ill-advised love affair.
This leads Thernstrom to meditate on the historical connections between the word “pain” and the Latin word for punishment “poena”. This excursion into history and language takes the reader through changing theologies and attitudes, and is typical of the second story of The Pain Chronicles: its pleasure in intellectual curiosity. Thernstrom follows her forensic curiosity down many byways in the history of pain and medicine, analgesia and anaesthesia. We learn both how the ancients understood pain and how contemporary researchers peer into the brain’s response to pain with real-time brain-imaging.
The Egyptian Ebers Papyrus from the 13th Century BC declares that “Magic is effective together with medicine. Medicine is effective together with magic.” “Although it would take millennia to understand why,” writes Thernstrom, “words in combination with physical treatment can alleviate pain in ways better than treatment alone.” (p. 35). She is clearly delighted to have affirmed that medications work better in a good healing relationship.
Some Christians believe that pain can lead one into the imitatio Christi. Elaine Scarry’s classic 1985 study The Body in Pain examines how the Bible understands pain, beginning with the pain of childbirth (“all those begats”) and following through the pain inflicted on God’s enemies in the Old Testament. Ultimately, claims Scarry, all this pain can only be understood through the lens of the Cross. Women’s pain, the pain of Israel’s enemies, and ultimately our pain should be viewed as a share in Christ’s Passion. After consideration, Thernstrom dismisses this idea as unhealthy: “I didn’t want to be in Pain. I didn’t want to want it. Pain is not a cross; it’s a Harrow.” (p. 76)
Ms Thernstrom cites studies that show “positive religious coping”. For some Christians, their faith does help them make sense of chronic pain by cognitive reframing the suffering or placing it in a wider context. For other Christians, however, pain leads to greater distress perhaps because they interpret their pain as punishment. (p. 206)
Hearing about the Hindu devotees who thread hooks through their flesh, Thernstrom heads to Kuala Lumpur to see whether they might have some insights into dealing with pain. Her journalist’s pen describes the festivals vividly, but they are of only marginal help on our journey. These pilgrims choose temporary pain to induce a spiritual high. This may lead to effective analgesia, but it is a practice worlds away from chronic pain: not choosing pain that never stops. No wonder the priest snorted when Thernstrom asked the god to take away the burden of her pain.
Thernstrom returns to science to make meaning of chronic pain. This malady is a disease of the brain, in fact, a disease of consciousness, that we cannot yet cure or treat effectively because brain science knows so little about consciousness.
She compares our current understanding of chronic pain to consumption in the 19th Century. Consumption was used as a metaphor for dying Romantic poets or operatic heroines. In 1882, a German physician identified mycobacterium tuberculosis. Although the cure, antibiotics, was half a century away, this scientific discovery reduced the illness from a metaphor to a disease. Chronic pain, Thernstrom concludes, currently evokes many metaphors, but until science unlocks its secrets, we will remain like pre-1882 sufferers of TB.
The Pain Chronicles cover much fascinating territory. Metaphors of pain and suffering are explored with elegance, intelligence and humanity. Melanie Thernstrom offers no theodicy of her own. She fears, I think, that to do so would belittle the experience of her fellow sufferers. What she does provide, though, is a fascinating sampling of others throughout history making meaning in chronic pain. While there may not yet be a cure for chronic pain, there is a lot of understanding here, and therefore comfort.