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The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering
Each of us will know physical pain in our lives, but none of us knows when it will come or how long it will stay. Today as much as 10 percent of the population of the United States suffers from chronic pain. It is more widespread, misdiagnosed, and undertreated than any major disease. While recent research has shown that pain produces pathological changes to the brain and spinal cord, many doctors and patients still labor under misguided cultural notions and outdated scientific dogmas that prevent proper treatment, to devastating effect.
In The Pain Chronicles , a singular and deeply humane work, Melanie Thernstrom traces conceptions of pain throughout the ages—from ancient Babylonian pain-banishing spells to modern brain imaging—to reveal the elusive, mysterious nature of pain itself. Interweaving first-person reflections on her own battle with chronic pain, incisive reportage from leading-edge pain clinics and medical research, and insights from a wide range of disciplines—science, history, religion, philosophy, anthropology, literature, and art—Thernstrom shows that when dealing with pain we are neither as advanced as we imagine nor as helpless as we may fear.
Both a personal meditation and an intellectual exploration, The Pain Chronicles illuminates and makes sense of the all-too-human experience of pain—and confronts with extraordinary grace and empathy its peculiar traits, its harrowing effects, and its various antidotes.
In The Pain Chronicles , a singular and deeply humane work, Melanie Thernstrom traces conceptions of pain throughout the ages—from ancient Babylonian pain-banishing spells to modern brain imaging—to reveal the elusive, mysterious nature of pain itself. Interweaving first-person reflections on her own battle with chronic pain, incisive reportage from leading-edge pain clinics and medical research, and insights from a wide range of disciplines—science, history, religion, philosophy, anthropology, literature, and art—Thernstrom shows that when dealing with pain we are neither as advanced as we imagine nor as helpless as we may fear.
Both a personal meditation and an intellectual exploration, The Pain Chronicles illuminates and makes sense of the all-too-human experience of pain—and confronts with extraordinary grace and empathy its peculiar traits, its harrowing effects, and its various antidotes.
384 pages, Hardcover
First published August 17, 2010
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1538 people want to read
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Displaying 1 - 30 of 155 reviews
March 22, 2011
I just don't have it in me to write a proper review of this book. I can't do it objectively, and I'm not in the mood to rant. Not much of a ranter even in the worst of circumstances.
If, like me, you're a chronic pain sufferer whose life has been defined and limited by your condition, you're not likely to find the book comforting or helpful. It's more likely to frustrate or anger you. If you are fortunate enough to be pain-free and want to study pain as a purely intellectual exercise, The Pain Chronicles may interest you.
The author herself claims to be among those with real chronic pain, but it's clear from the way she writes so coldly and clinically about the subject that she only THINKS she knows what it's like. We who live with it as a permanent, unrelenting condition could never write a book like this. It would come across as a self-pitying, sympathy-grubbing whine festival.
So, in the interest of fairness, because she was willing to write about pain studies, I can give Thernstrom two stars instead of one. Maybe the book will have some value in building a general understanding of pain and the various attempts to alleviate it. Just don't go into it looking for anything that will ease your own experience of pain.
If you live with pain as a constant, unremitting companion, you don't want science. You want to know how can I make it go away, or at least let up, for an hour, or even a few minutes? For that, I recommend books and CDs teaching breathing techniques. Andrew Weil and Jon Kabat-Zinn are especially good.
(How'd I do? All efforts to the contrary, this probably sounds like a self-pitying, sympathy-grubbing whine festival. Believe me, it coulda been MUCH worse.)
If, like me, you're a chronic pain sufferer whose life has been defined and limited by your condition, you're not likely to find the book comforting or helpful. It's more likely to frustrate or anger you. If you are fortunate enough to be pain-free and want to study pain as a purely intellectual exercise, The Pain Chronicles may interest you.
The author herself claims to be among those with real chronic pain, but it's clear from the way she writes so coldly and clinically about the subject that she only THINKS she knows what it's like. We who live with it as a permanent, unrelenting condition could never write a book like this. It would come across as a self-pitying, sympathy-grubbing whine festival.
So, in the interest of fairness, because she was willing to write about pain studies, I can give Thernstrom two stars instead of one. Maybe the book will have some value in building a general understanding of pain and the various attempts to alleviate it. Just don't go into it looking for anything that will ease your own experience of pain.
If you live with pain as a constant, unremitting companion, you don't want science. You want to know how can I make it go away, or at least let up, for an hour, or even a few minutes? For that, I recommend books and CDs teaching breathing techniques. Andrew Weil and Jon Kabat-Zinn are especially good.
(How'd I do? All efforts to the contrary, this probably sounds like a self-pitying, sympathy-grubbing whine festival. Believe me, it coulda been MUCH worse.)
December 7, 2010
this book was a chronic pain...in my ass. i really expected something more out of this book! it had positive reviews in the "new york times" & the "new yorker," & i was really hoping to connect with it, as i have suffered from chronic pain for over thirteen years. but it was such a disappointment.
the book is broken up into five big parts, each of which purports to examine the issue of pain from a slightly different perspective. the first part looks as the religious tradition of pain, & this is where the book & i got off on the wrong foot. there are few things i find more tedious than religion. there was all this shit about how some religions look upon pain as a curse or a justified punishment for sin. that's really great & everything, but i am not religious & do not look at pain that way, so it was really boring. the only thing about this section that was remotely interesting was the stuff about "trial by ordeal," but...
the major problem with this book is that each of the five sections is broken down into numerous sub-sections, anywhere from a page to maybe five pages in length. each tiny sub-section is a cursory examination of a small, limited aspect of examining the nature of pain--as a case study, in terms of medical breakthroughs, through the prism of the author's personal story, etc. as such, there was no space for any idea to really blossom & develop. it's like the book tried to be all things to all people who have ever experienced chronic pain, & the result was a frustrating hodgepodge of nothingness.
far & away the worst parts of the book were the bits about the author's own personal experiences of chronic pain. i know from personal experience how difficult it is to write about pain without coming across as whiny, selfish, & narcissistic. the writer did not succeed in any way in avoiding these pitfalls. often when writing about pain case studies (the author spent several years traveling to pain clinics & meeting with patients & their doctors), the author compares herself against other pain patients...generally in an effort to find the other pain patients lacking in some way. either they are not complying with potentially helpful treatments, or they expect unrealistic miracles from their doctors, or they complain too much about their pain, or their life activities indicate that their pain is not as bad as the author's. all of this was just awful to read & it made me HATE the author (her goofy, hideous author photo on the flap jacket also did her no favors--she looked like she was trying to look like a teenager). at one point, she writes about seeing an orthopedist & receiving a diagnosis of a degenerative shoulder condition. "will it get better?" she asks. he points out that it's DEGENERATIVE. which means, no, it won't get better. she seems dumbfounded by this information.
seriously? SERIOUSLY?! how is it that a college-educated writer who knows enough to seek out an orthopedic specialist apparently does not understand the meaning of the word "degenerative"? she also spends a lot of time feeling sorry for herself because she was diagnosed with arthritis at the tender age of 33. she waxes lyrical (in her own imagination) about how very young this is, & wonders how she can live out another fifty years of life with an arthritic shoulder. as someone who was diagnosed with arthritis in her spine, neck, hips, shoulders, knees, ankles, wrists, & hands at the age of 22, my sympathies were limited. suck it the fuck up & shut up.
i don't know who the audience for this book actually is, but i don't think it's for chronic pain sufferers. i learned pretty much nothing from this book, & not until page 290 does the author offer the tidbit that consciously thinking about pain (by, say, reading a book about chronic pain) can make pain worse. well, thanks. i'd kind of already caught on by then. there was nothing in this book that helped me find a better way of coping with my pain, or made me relate in some uplifting way to other chronic pain sufferers (particularly the author). the prose was stilted & excessively pretentious. it seems like an armchair book for people without chronic pain who think they are smart. i think each chronic pain sufferer needs to make their own decision about whether or not to subject themselves to this book. i acknowledge that there is some possibility that a chronic pain sufferer for whom maybe the condition is still new, or who feels more sad than i do about their pain, might glean some tidbits from this book. but don't say i didn't warn you. you're in for a rambling, incomprehensible, piteous, pretentious whinefest of epic proportions. proceed with caution.
the book is broken up into five big parts, each of which purports to examine the issue of pain from a slightly different perspective. the first part looks as the religious tradition of pain, & this is where the book & i got off on the wrong foot. there are few things i find more tedious than religion. there was all this shit about how some religions look upon pain as a curse or a justified punishment for sin. that's really great & everything, but i am not religious & do not look at pain that way, so it was really boring. the only thing about this section that was remotely interesting was the stuff about "trial by ordeal," but...
the major problem with this book is that each of the five sections is broken down into numerous sub-sections, anywhere from a page to maybe five pages in length. each tiny sub-section is a cursory examination of a small, limited aspect of examining the nature of pain--as a case study, in terms of medical breakthroughs, through the prism of the author's personal story, etc. as such, there was no space for any idea to really blossom & develop. it's like the book tried to be all things to all people who have ever experienced chronic pain, & the result was a frustrating hodgepodge of nothingness.
far & away the worst parts of the book were the bits about the author's own personal experiences of chronic pain. i know from personal experience how difficult it is to write about pain without coming across as whiny, selfish, & narcissistic. the writer did not succeed in any way in avoiding these pitfalls. often when writing about pain case studies (the author spent several years traveling to pain clinics & meeting with patients & their doctors), the author compares herself against other pain patients...generally in an effort to find the other pain patients lacking in some way. either they are not complying with potentially helpful treatments, or they expect unrealistic miracles from their doctors, or they complain too much about their pain, or their life activities indicate that their pain is not as bad as the author's. all of this was just awful to read & it made me HATE the author (her goofy, hideous author photo on the flap jacket also did her no favors--she looked like she was trying to look like a teenager). at one point, she writes about seeing an orthopedist & receiving a diagnosis of a degenerative shoulder condition. "will it get better?" she asks. he points out that it's DEGENERATIVE. which means, no, it won't get better. she seems dumbfounded by this information.
seriously? SERIOUSLY?! how is it that a college-educated writer who knows enough to seek out an orthopedic specialist apparently does not understand the meaning of the word "degenerative"? she also spends a lot of time feeling sorry for herself because she was diagnosed with arthritis at the tender age of 33. she waxes lyrical (in her own imagination) about how very young this is, & wonders how she can live out another fifty years of life with an arthritic shoulder. as someone who was diagnosed with arthritis in her spine, neck, hips, shoulders, knees, ankles, wrists, & hands at the age of 22, my sympathies were limited. suck it the fuck up & shut up.
i don't know who the audience for this book actually is, but i don't think it's for chronic pain sufferers. i learned pretty much nothing from this book, & not until page 290 does the author offer the tidbit that consciously thinking about pain (by, say, reading a book about chronic pain) can make pain worse. well, thanks. i'd kind of already caught on by then. there was nothing in this book that helped me find a better way of coping with my pain, or made me relate in some uplifting way to other chronic pain sufferers (particularly the author). the prose was stilted & excessively pretentious. it seems like an armchair book for people without chronic pain who think they are smart. i think each chronic pain sufferer needs to make their own decision about whether or not to subject themselves to this book. i acknowledge that there is some possibility that a chronic pain sufferer for whom maybe the condition is still new, or who feels more sad than i do about their pain, might glean some tidbits from this book. but don't say i didn't warn you. you're in for a rambling, incomprehensible, piteous, pretentious whinefest of epic proportions. proceed with caution.
August 8, 2010
it was so refreshing to get more information and perspective on pain. all the medical info on pain was fascinating (i didn't realize how pain begets pain, making the whole body more sensitive; how pain destroys your ability to modulate pain on a cellular level, and also causes brain atrophy; or how pain can be JUST PAIN, not a sign of injury or tissue damage).
i also really enjoyed the section on "pain as narrative." the idea of the difference between telic-centralizing (or integrative) and telic-decentralizing (or disintegrative) pain feels super useful to me. your telos is your purpose (hello, columbia lit-hum class). pain that furthers your purpose, like muscle soreness or trapeze bruises or even the pain of recovering from a surgery that will give your body more function, is actually less painful and causes less suffering. all my pain and disability over the past year has been telic-decentralizing. it's a threat to my identity. it undermines and destroys my sense of self. YES THANK YOU melanie thernstrom.
i also really enjoyed the section on "pain as narrative." the idea of the difference between telic-centralizing (or integrative) and telic-decentralizing (or disintegrative) pain feels super useful to me. your telos is your purpose (hello, columbia lit-hum class). pain that furthers your purpose, like muscle soreness or trapeze bruises or even the pain of recovering from a surgery that will give your body more function, is actually less painful and causes less suffering. all my pain and disability over the past year has been telic-decentralizing. it's a threat to my identity. it undermines and destroys my sense of self. YES THANK YOU melanie thernstrom.
December 5, 2010
Will add more to this review soon...
One of the best books I have read EVER. Not just on pain either. Should be required reading for:
Med students
Doctors who treat pain patients
Those who have chronic pain
Those who care for a person in pain.
Fantastic, not dry at all, as a quote on the back suggests, it's almost wrong to love this book so much, given the topic.
I've already recommended it to my doctors and my family--my daughter may go into neuroscience, so this is right up her ally.
One of the best books I have read EVER. Not just on pain either. Should be required reading for:
Med students
Doctors who treat pain patients
Those who have chronic pain
Those who care for a person in pain.
Fantastic, not dry at all, as a quote on the back suggests, it's almost wrong to love this book so much, given the topic.
I've already recommended it to my doctors and my family--my daughter may go into neuroscience, so this is right up her ally.
September 15, 2010
This book has been reviewed very favorably by all of the major reviewer sources, NYT, WSJ and so on. I suspect the reason that it was reviewed at all is that the author is one of their own – a journalist and writer. It also gets glowing reviews on Amazon.
Frankly, I don’t get it. This simply is not a 5 star book. While Melanie Thernstrom does do the public a favor in bringing to their attention the troublesome issue of pain, what we know and don’t know about it, and its mismanagement, it simply is not a 5 star book. It is OK.
Pain, especially pain of the kind that cannot be seen by others (chronic pain is usually invisible to everyone but the sufferer) has for too many years resulted in stigma and the disdain of the public and sadly the medical profession. It is much like depression was years ago (and still is to some) thought to be a matter of pulling oneself up by bootstraps and get off the pity potty. The condition/phenomenon “pain” is under-researched and misunderstood, and the victim is blamed for their disability.
To make matters worse, unscrupulous “pain specialists” periodically pop up and turn their practice into legal drug pushing, thereby tainting legitimate pain specialists. Added to this is the U.S. attitudes toward opiates and the Christian glorification of suffering, and the poor patient suffering from chronic pain stands no chance.
The best parts of this book were Thernstrom’s discussion of the nature of pain, in which she explains some very difficult biological and physiological concepts and the research being done in this arena; and the complex emotions that are tied up with being a patient with chronic pain. In those two areas, this book is a tour de force for consumers.
There are a few down sides. I disliked the choppy little vignette like chapters – if that is what they could be called. Rather than develop a few concepts well, she gives us cliff notes of many ideas. Also, there is a tone throughout that I really cannot put my finger on but that I found off-putting. I thought that there was more than a bit of overkill in her explorations of all of these pain patients and a voyeuristic quality to her observations. I also felt as though she was seeking, not enlightenment, but validation of her own status and feelings/behaviors as a pain patient. That is fine, but exploring those kinds of issues is the role of therapy, and I am not sure I want to hear about someone else’s psychotherapy. Woody Allen??? It got boring with him, and it got boring here.
All in all, I think that she would have done a better service to people who are looking for answers about their chronic pain had she taken a less “literary” approach to this book. People who are looking for answers would find the digressions into history and culture to be a digression – and frankly “illness as metaphor” has already been done. Glad I got it when it came into my local library and did not spend my money.
Frankly, I don’t get it. This simply is not a 5 star book. While Melanie Thernstrom does do the public a favor in bringing to their attention the troublesome issue of pain, what we know and don’t know about it, and its mismanagement, it simply is not a 5 star book. It is OK.
Pain, especially pain of the kind that cannot be seen by others (chronic pain is usually invisible to everyone but the sufferer) has for too many years resulted in stigma and the disdain of the public and sadly the medical profession. It is much like depression was years ago (and still is to some) thought to be a matter of pulling oneself up by bootstraps and get off the pity potty. The condition/phenomenon “pain” is under-researched and misunderstood, and the victim is blamed for their disability.
To make matters worse, unscrupulous “pain specialists” periodically pop up and turn their practice into legal drug pushing, thereby tainting legitimate pain specialists. Added to this is the U.S. attitudes toward opiates and the Christian glorification of suffering, and the poor patient suffering from chronic pain stands no chance.
The best parts of this book were Thernstrom’s discussion of the nature of pain, in which she explains some very difficult biological and physiological concepts and the research being done in this arena; and the complex emotions that are tied up with being a patient with chronic pain. In those two areas, this book is a tour de force for consumers.
There are a few down sides. I disliked the choppy little vignette like chapters – if that is what they could be called. Rather than develop a few concepts well, she gives us cliff notes of many ideas. Also, there is a tone throughout that I really cannot put my finger on but that I found off-putting. I thought that there was more than a bit of overkill in her explorations of all of these pain patients and a voyeuristic quality to her observations. I also felt as though she was seeking, not enlightenment, but validation of her own status and feelings/behaviors as a pain patient. That is fine, but exploring those kinds of issues is the role of therapy, and I am not sure I want to hear about someone else’s psychotherapy. Woody Allen??? It got boring with him, and it got boring here.
All in all, I think that she would have done a better service to people who are looking for answers about their chronic pain had she taken a less “literary” approach to this book. People who are looking for answers would find the digressions into history and culture to be a digression – and frankly “illness as metaphor” has already been done. Glad I got it when it came into my local library and did not spend my money.
November 16, 2018
A little surprised to see the harshness of some reviews on here! So in the interest of expectation-setting: this book reads more like a piece of extended journalism than a self-help book or poetic memoir, so if it’s answers you’re looking for, you will no doubt be disappointed. If, however, you fancy learning about the science of pain, along with some history of religion and a few anecdotal interludes, then you and this book will get on well. I really enjoyed it, especially as I’m not a huge non-fiction fan (or should I say, I like learning, but I often find non-fiction books dry, particularly if there’s science involved!).
I think it also bears mentioning that I am a chronic pain sufferer. I do not think Thernstrom has somehow let down the pain community, nor would I dare judge the validity of severity of her pain. She’s made an entertaining piece of investigative journalism, and presented ways humans have tried and continue to try to deal with pain. That’s all. And for me, that’s more than enough.
I think it also bears mentioning that I am a chronic pain sufferer. I do not think Thernstrom has somehow let down the pain community, nor would I dare judge the validity of severity of her pain. She’s made an entertaining piece of investigative journalism, and presented ways humans have tried and continue to try to deal with pain. That’s all. And for me, that’s more than enough.
October 1, 2010
This is a fabulous book but would probably only interest those who suffer some sort of intense chronic pain. It has a lot of great information on how the pain of whatever medical condition you may have actually affects you, shares research on pain, goes through the history of pain, and she sites examples of cases.
She also shares her personal history which can be somewhat overdone at times. But the reality is most people who have severe chronic pain feel alone or often despair at least at some point, so her story is probably important to a point to the general audience of the book.
She certainly offers her own perspective at times. For example, I am personally not keen on opiates unless you are at the point of wanting to off yourself from pain. Then, I say go for it. But we all should make our own decisions. So what she says is not gold.
There is some information I sure didn't know in here but isn't surprising. Hey, I didn't know the grey matter was rotting in my head at a quicker pace than normal folks from these migraines. Awesome, I feel dumber than a doornail from the drugs I take anyway and this just puts me a quicker path to true idiocy. Hey, the boys seem to like me this way. What are you gonna do? Oy vay.
She also shares her personal history which can be somewhat overdone at times. But the reality is most people who have severe chronic pain feel alone or often despair at least at some point, so her story is probably important to a point to the general audience of the book.
She certainly offers her own perspective at times. For example, I am personally not keen on opiates unless you are at the point of wanting to off yourself from pain. Then, I say go for it. But we all should make our own decisions. So what she says is not gold.
There is some information I sure didn't know in here but isn't surprising. Hey, I didn't know the grey matter was rotting in my head at a quicker pace than normal folks from these migraines. Awesome, I feel dumber than a doornail from the drugs I take anyway and this just puts me a quicker path to true idiocy. Hey, the boys seem to like me this way. What are you gonna do? Oy vay.
May 28, 2020
The author, who suffers from chronic pain herself, takes a deep dive into the history of how pain was understood as well as modern day science.
There are two types of books about pain - the first is a fairly unemotional rendition of facts and science. The second includes facts and science as well, but it's used to further understand the chronic pain that the author is going through. This second type also includes tips and hints for how to better survive a life that is shaped by pain.
"The Pain Chronicles" is an example of the former. I honestly skimmed a lot of the history because I don't care about how Egyptians viewed pain. It had few 'useful' bits - the 'chronic pain is a disease, just like diabetes is a disease' is something I'll remind myself of. When I read one of these books that try to explain what it's like to live constantly hampered by pain, I'm looking for help. What can I do to feel better and fight back? If you're looking for a book like that, try "Backbone" by Karen Duffy. And if you're looking for the history and science interwoven with the author's story, take a look at "Ask Me About My Uterus" by Abby Norman. Both are more interesting and helpful than this one.
There are two types of books about pain - the first is a fairly unemotional rendition of facts and science. The second includes facts and science as well, but it's used to further understand the chronic pain that the author is going through. This second type also includes tips and hints for how to better survive a life that is shaped by pain.
"The Pain Chronicles" is an example of the former. I honestly skimmed a lot of the history because I don't care about how Egyptians viewed pain. It had few 'useful' bits - the 'chronic pain is a disease, just like diabetes is a disease' is something I'll remind myself of. When I read one of these books that try to explain what it's like to live constantly hampered by pain, I'm looking for help. What can I do to feel better and fight back? If you're looking for a book like that, try "Backbone" by Karen Duffy. And if you're looking for the history and science interwoven with the author's story, take a look at "Ask Me About My Uterus" by Abby Norman. Both are more interesting and helpful than this one.
December 26, 2020
I chose to read this while thinking about two individuals I have known who have chronic pain conditions -- and concluded I might not encourage either of them to read it. This is an extremely intellectual look at something I presume to be very personal and unique: an exhaustive look at what has been believed, researched, studied and examined about pain over many hundreds of years. What it doesn't have is much in the way of encouragement or hope. One can only conclude that pain remains one of the last great mysteries. Reading this book might compare in some small way to the journeys so many patients make, seeking out one more doctor, one more possible treatment, one more hope for respite. I hope never to join their company.
March 30, 2018
An excellent, informative read on the chronic illness of pain. I appreciated how Melanie Thernstrom was able to weave her own story of pain into the material, but it never felt that it was overshadowing the research or stories from other chronic pain sufferers.
I would recommend this book for a fuller picture of chronic pain and its treatments. Thernstrom does a great job exploring medicine, alternative medicine, as well as exploring religious aspects of suffering and meaning making.
I would recommend this book for a fuller picture of chronic pain and its treatments. Thernstrom does a great job exploring medicine, alternative medicine, as well as exploring religious aspects of suffering and meaning making.
November 23, 2011
Well written and meticulously researched, this was one of the most interesting books I've read in a while. The author is a chronic pain sufferer, which explains her interest. The beginning of the book is her story; how she developed the pain and how she lived with it. This part was irritating to me, because she seemed SO wishy washy about how to help herself, and how she felt like she had to hide it from the man (and eventually, other men) in her life. She also did not pursue treatment as aggressively as she should have. When I had my chronic pain, I did everything I could to try to fix myself. How Thernstrom made it through year after year, I cannot imagine.
The best part of the book is all the amazing and scary statistics and gems about pain. Men and women have different pain receptors (mu vs kappa) and so they need different drugs. Pain truly does cause loss of gray matter in the brain, which affects memory and reasoning. Women show pain differently, and therefore they are perceived differently by doctors (Listen up, MD's: we are not hysterical...we are in PAIN!!).
I got this book from the library, but will get my own copy so I can highlight and write in the margins. Anyone who is in chronic pain, deals with someone who is, or who just wants to learn some very cool facts about the history and theory of why things hurt us should get this immediately.
The best part of the book is all the amazing and scary statistics and gems about pain. Men and women have different pain receptors (mu vs kappa) and so they need different drugs. Pain truly does cause loss of gray matter in the brain, which affects memory and reasoning. Women show pain differently, and therefore they are perceived differently by doctors (Listen up, MD's: we are not hysterical...we are in PAIN!!).
I got this book from the library, but will get my own copy so I can highlight and write in the margins. Anyone who is in chronic pain, deals with someone who is, or who just wants to learn some very cool facts about the history and theory of why things hurt us should get this immediately.
January 13, 2018
I was surprised by how much I enjoyed this book, considering I just picked it off the shelf at random (the shelf wasn't random, though). I don't care that the Babylonians thought that toothaches were caused by magic worms sent by the gods, and the writing started out too lyrical for my taste. But once the book got into modern times, I was fascinated. It answered questions a friend and I had just been asking about the genesis of modern drugs (Tylenol was a pharmacist's mistake, and willow bark (aspirin) came into use (besides Hippocrates) because Rev. Edmund Stone reasoned that the wet dirt they grew in caused disease).
I was impressed by the depth of research. I can't recall another book which details an interview with a person ... and then follows up with the person years later. The evolution of a person's situation and attitude over time is very compelling, particularly if you "meet" them before the end of their story. I also got a kick out of reading about Dr. Sean Mackey of Stanford. I met the man for about 2 minutes, and he was intimidating and so brusque that the fellow later apologized to me for his manner. I fell over laughing reading about Dr. Mackey's study on the effects of infatuation on pain tolerance. *That* drill sergeant knows about puppy love? Anyway.
I liked that the author weaves in descriptions of her own journey with pain, and it was one of the better romantic stories I've read when she finally found a man who treated her well concerning her pain (unlike the series of douche bags she dated before). I also liked the longer term descriptions of some of the patients, particularly Dani who finally found relief with doctor number 85(!).
This book is palatable because it is not written for people with chronic pain. It is definitely not a self-help book. If you are in pain it will only make things worse, because there is very little good news.
I marked so many passages to remember that my book is bristling with sticky-notes. Here they are:
"In recent years, a new paradigm of pain has emerged [...]. The contemporary model of pain sees it as a complex interaction among parts of the brain. While founded on the same scientific traditions that gave rise to the nineteenth-century view, it has also revealed the truth embedded in the nonscientific, premodern model by showing the way in which pain is inherently meaningful because it is not simply a matter of nerves firing, but an experience created by meaning-making parts of the brain." p8
"When pain persists, these changes begin to be a source of pain themselves. Contracted muscles clamp down on nerves and cause pain. The rigid muscles cause postural changes that strain other muscles. Using the affected area hurts, so one guards it, which deprives it of exercise, which makes the muscles atrophy, which in turn makes it harder to use that area and causes more pain." p55
"Botched operations were the rule: in 1834 a surgeon generated controversy when he was quoted saying candidly that before a man could successfully perform cataract surgeries, he must first 'spoil a hatful of eyes.' [...] About a third of patients died from such surgeries." p93
"Unlike modern physicians, who focus on curing disease, ancient healers were primarily renowned for their anodynes. [...] only a few were true analgesics: opium from poppies, alcohol, cocaine from the coca plant, henbane, mandrake (mandragora), deadly nightshade (belladonna), cannabis (marijuana), and salicylic acid (similar to aspirin) found in willow bark or dried myrtle leaves." p101
People used to calm babies with syrups containing opium (p102)
"Although there is a scientific consensus about the reality of the [chronic pain] disease, it has not gained widespread acceptance outside the small circle of pain specialists." p130
"A patient who comes in with twenty years of back pain is more than twenty times less likely to get well than one who comes in after just six weeks." p145
If their pain is still there but their doctor is nice, patients assume that there is nothing that can be done for their pain, and they say they are satisfied with their doctors. p153
"There is increasing evidence that both conditions involve abnormalities in the neurotransmitters serotonin and norepinephrine, which play a role not only in mood disorders but in the gate-control mechanisms of pain. [...] Pain decreases available serotonin (by increasing the rate at which it is reabsobed), which weakens the pain-modulation system, creates more pain, and creates depression. Thus, we can see that anxiety and depression are not merely cognitive or affective responses to pain; they are physiologic consequences of it. [... Dr. Beritbart says,] 'Seotonin facilitates descending analgesia' (the brain's ability to modulate pain in the spinal cord by stopping incoming pain messages), 'and chronic pain uses up serotonin, like a car running out of gas. If the pain persists long enough, everybody runs out of gas.' [...] To make stress reduction a primary strategy for pain treatment is like counseling a drowning person to relax." p157-158.
"In much of China and Africa, opioids are largely unavailable or prohibited." p 159
A meta-analysis of 25 studies put the average risk of opioid addiction at 3%, and 0.19% for chronic pain patients with no history of addiction. "'We live in a medical society that would rather prevent one addict from being formed than treat a hundred suffering,' Dr. Scott Fishman observes." p 161
Women and men react differently to the same pain medications (and many new medications are tested only on men, so the ones manufactured are the ones that work best for men). Redhaired women need more opioids than dark-haired women for the same analgesic effects. p176. Infants used to be circumcised without anesthesia (seriously?), p177. Chronic pain patients lose about twice as much gray matter per year as normal subjects, p186 People can be put off by doctors quoting statistics and refusing to be pinned down, instead of being reassuring.
"It has often been observed that male and female patients with complaints of pain are treated differently. Men are more likely to be given opioid medications, surgery, and complete exams, while women are given psychotropic medications for depression and anxiety. [...] Women tend to be either less aggressive in demanding pain treatment or aggressive in ways that are dismissed as mere hysteria." p 167-168 Thus the problem mentioned by women - if they present themselves as assertive and well-groomed, they are not perceived to be ill. If they don't, they are dismissed as a basket case.
Sophocles wrote, "One word frees us of all the weight and pain of life: That word is love." p202
"A significant percent of women used to complain of chronic pain following radical mastectomies. Their pain was often interpreted as a psychological phenomenon: they were just 'missing' their breasts. But in the early 1980s, Dr. Kathleen Foley [...] identified the pain as being caused by the severing of a major thoracic nerve during surgery." p218 So basically, up to the present day, unexplained medical problems are caused by "spirits" and women are crazy, until a (female) scientist finds the real reason.
"Studies suggest that one of the best predictors of whether a patient will adhere to a treatment plan is the patient's relationship with his or her doctor." p230
"'Build ... an illness narrative that will make sense of and give value to the experience,' the medical anthropologist Arthur Kleinman enjoins." p243
"Neuroimaging studies show that a placebo activates the brain's pain-modulatory system in a way that is neurochemically indistinguishable from treatment with an opioid analgesic. [...] The use of a placebo increases morphine's efficacy by more than a third (with the placebo in this example being simply the positive expectations created by telling patients they have been given morphine and will soon feel great relief.)" p292 "'It's a pregnant irony that striving for the placebo effect is a frank contradiction to what clinical practice is all about. It's frustrating that you can[t use this simple tool that works so well in experiments. But a relationship with a doctor is one of the most important human interactions. [...] And honesty is the foundation of that experience.'" Dr. John Keltner. p296
Acupuncture, which is used (sometimes) effectively for surgical anesthesia in China, seems to be largely hypnosis. p298
Dr. Mackey believes that functional imaging and genetic testing, with machine learning and other new technologies, will eventually help doctors to identify effective pain therapies for specific pain patients faster than the current trial-and-error method. Other doctors don't think imaging is going to help much, because pain is so complicated. After all, we know where in the brain we see, but where in the brain is beauty?
I was impressed by the depth of research. I can't recall another book which details an interview with a person ... and then follows up with the person years later. The evolution of a person's situation and attitude over time is very compelling, particularly if you "meet" them before the end of their story. I also got a kick out of reading about Dr. Sean Mackey of Stanford. I met the man for about 2 minutes, and he was intimidating and so brusque that the fellow later apologized to me for his manner. I fell over laughing reading about Dr. Mackey's study on the effects of infatuation on pain tolerance. *That* drill sergeant knows about puppy love? Anyway.
I liked that the author weaves in descriptions of her own journey with pain, and it was one of the better romantic stories I've read when she finally found a man who treated her well concerning her pain (unlike the series of douche bags she dated before). I also liked the longer term descriptions of some of the patients, particularly Dani who finally found relief with doctor number 85(!).
This book is palatable because it is not written for people with chronic pain. It is definitely not a self-help book. If you are in pain it will only make things worse, because there is very little good news.
I marked so many passages to remember that my book is bristling with sticky-notes. Here they are:
"In recent years, a new paradigm of pain has emerged [...]. The contemporary model of pain sees it as a complex interaction among parts of the brain. While founded on the same scientific traditions that gave rise to the nineteenth-century view, it has also revealed the truth embedded in the nonscientific, premodern model by showing the way in which pain is inherently meaningful because it is not simply a matter of nerves firing, but an experience created by meaning-making parts of the brain." p8
"When pain persists, these changes begin to be a source of pain themselves. Contracted muscles clamp down on nerves and cause pain. The rigid muscles cause postural changes that strain other muscles. Using the affected area hurts, so one guards it, which deprives it of exercise, which makes the muscles atrophy, which in turn makes it harder to use that area and causes more pain." p55
"Botched operations were the rule: in 1834 a surgeon generated controversy when he was quoted saying candidly that before a man could successfully perform cataract surgeries, he must first 'spoil a hatful of eyes.' [...] About a third of patients died from such surgeries." p93
"Unlike modern physicians, who focus on curing disease, ancient healers were primarily renowned for their anodynes. [...] only a few were true analgesics: opium from poppies, alcohol, cocaine from the coca plant, henbane, mandrake (mandragora), deadly nightshade (belladonna), cannabis (marijuana), and salicylic acid (similar to aspirin) found in willow bark or dried myrtle leaves." p101
People used to calm babies with syrups containing opium (p102)
"Although there is a scientific consensus about the reality of the [chronic pain] disease, it has not gained widespread acceptance outside the small circle of pain specialists." p130
"A patient who comes in with twenty years of back pain is more than twenty times less likely to get well than one who comes in after just six weeks." p145
If their pain is still there but their doctor is nice, patients assume that there is nothing that can be done for their pain, and they say they are satisfied with their doctors. p153
"There is increasing evidence that both conditions involve abnormalities in the neurotransmitters serotonin and norepinephrine, which play a role not only in mood disorders but in the gate-control mechanisms of pain. [...] Pain decreases available serotonin (by increasing the rate at which it is reabsobed), which weakens the pain-modulation system, creates more pain, and creates depression. Thus, we can see that anxiety and depression are not merely cognitive or affective responses to pain; they are physiologic consequences of it. [... Dr. Beritbart says,] 'Seotonin facilitates descending analgesia' (the brain's ability to modulate pain in the spinal cord by stopping incoming pain messages), 'and chronic pain uses up serotonin, like a car running out of gas. If the pain persists long enough, everybody runs out of gas.' [...] To make stress reduction a primary strategy for pain treatment is like counseling a drowning person to relax." p157-158.
"In much of China and Africa, opioids are largely unavailable or prohibited." p 159
A meta-analysis of 25 studies put the average risk of opioid addiction at 3%, and 0.19% for chronic pain patients with no history of addiction. "'We live in a medical society that would rather prevent one addict from being formed than treat a hundred suffering,' Dr. Scott Fishman observes." p 161
Women and men react differently to the same pain medications (and many new medications are tested only on men, so the ones manufactured are the ones that work best for men). Redhaired women need more opioids than dark-haired women for the same analgesic effects. p176. Infants used to be circumcised without anesthesia (seriously?), p177. Chronic pain patients lose about twice as much gray matter per year as normal subjects, p186 People can be put off by doctors quoting statistics and refusing to be pinned down, instead of being reassuring.
"It has often been observed that male and female patients with complaints of pain are treated differently. Men are more likely to be given opioid medications, surgery, and complete exams, while women are given psychotropic medications for depression and anxiety. [...] Women tend to be either less aggressive in demanding pain treatment or aggressive in ways that are dismissed as mere hysteria." p 167-168 Thus the problem mentioned by women - if they present themselves as assertive and well-groomed, they are not perceived to be ill. If they don't, they are dismissed as a basket case.
Sophocles wrote, "One word frees us of all the weight and pain of life: That word is love." p202
"A significant percent of women used to complain of chronic pain following radical mastectomies. Their pain was often interpreted as a psychological phenomenon: they were just 'missing' their breasts. But in the early 1980s, Dr. Kathleen Foley [...] identified the pain as being caused by the severing of a major thoracic nerve during surgery." p218 So basically, up to the present day, unexplained medical problems are caused by "spirits" and women are crazy, until a (female) scientist finds the real reason.
"Studies suggest that one of the best predictors of whether a patient will adhere to a treatment plan is the patient's relationship with his or her doctor." p230
"'Build ... an illness narrative that will make sense of and give value to the experience,' the medical anthropologist Arthur Kleinman enjoins." p243
"Neuroimaging studies show that a placebo activates the brain's pain-modulatory system in a way that is neurochemically indistinguishable from treatment with an opioid analgesic. [...] The use of a placebo increases morphine's efficacy by more than a third (with the placebo in this example being simply the positive expectations created by telling patients they have been given morphine and will soon feel great relief.)" p292 "'It's a pregnant irony that striving for the placebo effect is a frank contradiction to what clinical practice is all about. It's frustrating that you can[t use this simple tool that works so well in experiments. But a relationship with a doctor is one of the most important human interactions. [...] And honesty is the foundation of that experience.'" Dr. John Keltner. p296
Acupuncture, which is used (sometimes) effectively for surgical anesthesia in China, seems to be largely hypnosis. p298
Dr. Mackey believes that functional imaging and genetic testing, with machine learning and other new technologies, will eventually help doctors to identify effective pain therapies for specific pain patients faster than the current trial-and-error method. Other doctors don't think imaging is going to help much, because pain is so complicated. After all, we know where in the brain we see, but where in the brain is beauty?
August 17, 2010
Melanie Thernstrom has written brilliant books before -- such as her examination of a murder/suicide at Harvard -- but this may be her very best. I've also very much enjoyed her frequent New York Times articles on pain and other topics. Her writing is consistently interesting and highly insightful, as well as graceful in every sentence. She is especially adept at weaving memoir and personal stories in with topics in intellectual history and science.
I loved THE PAIN CHRONICLES for all the same reasons that I loved Andrew Solomon's THE NOONDAY DEMON, and I think it's fair to say that THE PAIN CHRONICLES does for pain what THE NOONDAY DEMON does for depression. In both books, the author faces a potentially crippling medical issue and fights hard to vanquish it. Both authors try different, fascinating approaches, and fight a strong fight. Both use their formidable skills as journalists to not only address their own predicament, but to cast light on an epidemic -- but until very recently, poorly-understood -- disease. Along the way, both learn much more than they originally knew about the disease that is afflicting them -- and there are many surprises in the mix. No wonder Solomon loved the book and blurbed it. Neither author finds a cure-all; both find much reason for hope.
Thernstrom not only tells her own, fascinating story, but also tells other pain patients' stories and recounts her conversations with eminent pain doctors. If you suffer from pain, this book is invaluable -- it gives you a birds' eye view of the state of the art in pain treatment, coupled with patients' specific experience and doctor's specific advice, right and wrong. If you don't suffer from pain, the book remains completely fascinating. Thernstrom investigates how other cultures treat pain and provides a fascinating (and at times horrifying) intellectual history of pain treatment.
In short, I couldn't more highly recommend this book.
I loved THE PAIN CHRONICLES for all the same reasons that I loved Andrew Solomon's THE NOONDAY DEMON, and I think it's fair to say that THE PAIN CHRONICLES does for pain what THE NOONDAY DEMON does for depression. In both books, the author faces a potentially crippling medical issue and fights hard to vanquish it. Both authors try different, fascinating approaches, and fight a strong fight. Both use their formidable skills as journalists to not only address their own predicament, but to cast light on an epidemic -- but until very recently, poorly-understood -- disease. Along the way, both learn much more than they originally knew about the disease that is afflicting them -- and there are many surprises in the mix. No wonder Solomon loved the book and blurbed it. Neither author finds a cure-all; both find much reason for hope.
Thernstrom not only tells her own, fascinating story, but also tells other pain patients' stories and recounts her conversations with eminent pain doctors. If you suffer from pain, this book is invaluable -- it gives you a birds' eye view of the state of the art in pain treatment, coupled with patients' specific experience and doctor's specific advice, right and wrong. If you don't suffer from pain, the book remains completely fascinating. Thernstrom investigates how other cultures treat pain and provides a fascinating (and at times horrifying) intellectual history of pain treatment.
In short, I couldn't more highly recommend this book.
February 2, 2011
If you suffer from chronic pain, I do not recommend this book. I imagine that as a subject matter of general interest it might appeal to some. The author takes a look at pain from many cultures, points in history and its place in medicine. She also tries to weave in her own story of suffering from chronic pain. It is a very broad and far reaching endeavor. Unfortunately, as a result, she does not take enough time to truly delve into any of the topics thoroughly. The historical references are so brief that it is impossible to get a context for any of it.
While, as a person who suffers from a chronic pain condition, I was hoping for more of a personal account that I could relate to I felt that her attempt to go above her personal history and make it academic was half hearted. The frequent parenthetical remarks about her own personal experience and condition within the context of a supposed scientific or academic approach was sophomoric. If the author had made a decision to write a memoir about her experience it could have been a quality piece. If the author had decided to write an academic piece on the historical, social and scientific aspects of pain it could have been excellent also. This hodgepodge of the two mushed up together, however, was a total miss, in my opinion.
While, as a person who suffers from a chronic pain condition, I was hoping for more of a personal account that I could relate to I felt that her attempt to go above her personal history and make it academic was half hearted. The frequent parenthetical remarks about her own personal experience and condition within the context of a supposed scientific or academic approach was sophomoric. If the author had made a decision to write a memoir about her experience it could have been a quality piece. If the author had decided to write an academic piece on the historical, social and scientific aspects of pain it could have been excellent also. This hodgepodge of the two mushed up together, however, was a total miss, in my opinion.
July 7, 2011
When I first started reading this book, it seemed promising, and I had a look at some of the negative reviews posted here and thought that the reviewers were being overly harsh, but about halfway through the book I saw their point.
The author doesn't understand science enough to explain any of the underlying medical concepts in a way that would be helpful to the reader, so she darts around dabbling in this and that, and pulling the whole mess of a book together with a personal memoir so bratty that all I could think was, "Would someone please tell this woman she isn't anywhere near as interesting as she thinks she is, and that all of us are tired of hearing about her overprivileged life and how hard it is?"
If you've ever been stuck in a doctor's waiting room where there's a 30- something woman with expensive shoes and a very fresh haircut talking on her smartphone about her personal life in a loud whiny, grievance filled tone in a manner that suggests no one else in the room is actually alive--well that's pretty much the feeling this author gave me.
There's nothing in this book that will be of the faintest use to anyone dealing with a chronic pain syndrome. The best book I've ever found for dealing with intolerable physical conditions continues to be Healing into Life And Death by Stephen Levine.
The author doesn't understand science enough to explain any of the underlying medical concepts in a way that would be helpful to the reader, so she darts around dabbling in this and that, and pulling the whole mess of a book together with a personal memoir so bratty that all I could think was, "Would someone please tell this woman she isn't anywhere near as interesting as she thinks she is, and that all of us are tired of hearing about her overprivileged life and how hard it is?"
If you've ever been stuck in a doctor's waiting room where there's a 30- something woman with expensive shoes and a very fresh haircut talking on her smartphone about her personal life in a loud whiny, grievance filled tone in a manner that suggests no one else in the room is actually alive--well that's pretty much the feeling this author gave me.
There's nothing in this book that will be of the faintest use to anyone dealing with a chronic pain syndrome. The best book I've ever found for dealing with intolerable physical conditions continues to be Healing into Life And Death by Stephen Levine.
June 5, 2018
Imagine, if you will, life before anesthesia when soldiers routinely underwent amputations and women, mastectomies without any numbing of the pain. And yet people thought that this suffering served a purpose. When ether was first used in surgeries, the Christians fought against it, citing Biblical passages such as Eve's punishment to bring forth children in pain. And though now we know that acute pain does serve a purpose: to warn the body of an illness or injury, chronic pain, on the other hand serves no purpose and detracts from the joy of living.
This is a book about chronic pain, and while that does not seem like a very entertaining premise, I found the book fascinating. The history and variety of ways to treat and to view pain is astonishing.
This is a book about chronic pain, and while that does not seem like a very entertaining premise, I found the book fascinating. The history and variety of ways to treat and to view pain is astonishing.
February 6, 2023
The Pain Chronicles provides an abundance of historical, medical, religious, and personal insights into chronic pain in a way that conveys the sheer complexity of it. Reading this book frustrated me for the same reason chronic pain greatly affects so many people: even with the invention of anesthesia and all the medical knowledge we have gained on the origins and mechanisms of chronic pain, we still seem to be eons away from effectively treating it. Acute pain is a different issue that we have gained some mastery over—but chronic pain is maladaptive, when our body is no longer warning us of tissue damage but is rather rewiring itself to often debilitating degrees without any evolutionary reason.
To preface, I can imagine that the reception of this book would vary widely between those who experience chronic pain and those who are reading about the topic for their own interest. As someone who does not experience it, I found that the book has given me ideas for what to think and inquire about in my future patient encounters. However, I do not anticipate this book as being particularly helpful to people who do experience chronic pain. It is more of an academic exploration of what makes up pain and the advancements we have made in understanding and treating it, but it does not contain much readily applicable advice for patients themselves.
With that being said, I learned a great deal from this book. During my Family Medicine placement for medical school, chronic pain has been one of the most common presentations I have seen. Some of these patients have an identifiable time of onset—such as a motor vehicle accident—whereas others have had an insidiously worsening pain over years without a clear inciting injury. All of the patients I have seen have had coexisting psychiatric conditions, namely depression. Thernstorm explores the question of which tends to come first, and the answer is an unsurprisingly complicated one: our pain- and emotion-regulating pathways share the same hormones, past traumas can sometimes manifest as future chronic pain, some people can be genetically predisposed to it, and in many cases the chronic pain is what gives rise to depression due to its impacts on quality of life. However, pain and mental health are inextricably linked in that affecting one will affect the other, which occurs in both negative and positive directions. And the connection is not just abstract; as an example, depression may decrease one’s motivation to stay physically active, which causes muscle weakening and eventually atrophy. This then places further strain on joints and muscles. Another example is that of pain regulation requiring serotonin and dopamine, which depletes these neurotransmitters also involved in regulating mood.
Despite this information, this book also reminds us of the dangers of jumping to the mind-body conclusion—generally, patients do not enjoy being told that the pain is “in their head.” Falsely attributing chronic pain to unresolved disputes or past traumas can inadvertently alienate the patient and prevent a trusting relationship from being formed with their healthcare provider. Indeed, a multitude of factors are at play; there is evidence suggesting that patients who have a positive relationship with the healthcare provider treating their pain generally have greater improvements in pain outcomes following intervention compared to those who have negative relationships. There is a fine line between explaining to a patient that belief and an internal locus of control have been shown to measurably alleviate pain versus implying to them that they have simply made up their pain. Medications do help, but so does the mind. Having this tricky discussion makes the practice of medicine an art as much as it is a science.
In the end, there are indeed pockets of knowledge that are valuable to our understanding of chronic pain, but—perhaps impossible to achieve—we do not have a unifying theory for it. This book is full of seeming contradictions not due to poor writing, but due to the nature of chronic pain. The jumping from one argument to another and then back again represents how individual and variable the experience of chronic pain is. It is truly based on the person’s unique context; what helps one may not help another. Some might want to see their pain as a disease whereas others might want to see that there is actually nothing wrong with them. Some might want their doctors to identify and treat a specific physical cause whereas others might wish their doctors would approach their pain more holistically. Pain is multifaceted, to say the least—there is much content from the book that I have not mentioned in this review due to their sheer complexity, such as the role of religion and spirituality in the experience of pain. In those cases, people have managed to dissociate themselves from their pain through seeing it as a bridge between them and a greater purpose. It is unmistakable that members of several religions and cultural traditions have been able to find meaning in pain, and even experience a pain-free state with what would typically cause people significant pain. All of this goes to show that as much as the physiology of pain can be discovered and explained, it also cannot be. It is a deeply human experience that is intertwined with our identities and our ideas about what pain means to us.
To preface, I can imagine that the reception of this book would vary widely between those who experience chronic pain and those who are reading about the topic for their own interest. As someone who does not experience it, I found that the book has given me ideas for what to think and inquire about in my future patient encounters. However, I do not anticipate this book as being particularly helpful to people who do experience chronic pain. It is more of an academic exploration of what makes up pain and the advancements we have made in understanding and treating it, but it does not contain much readily applicable advice for patients themselves.
With that being said, I learned a great deal from this book. During my Family Medicine placement for medical school, chronic pain has been one of the most common presentations I have seen. Some of these patients have an identifiable time of onset—such as a motor vehicle accident—whereas others have had an insidiously worsening pain over years without a clear inciting injury. All of the patients I have seen have had coexisting psychiatric conditions, namely depression. Thernstorm explores the question of which tends to come first, and the answer is an unsurprisingly complicated one: our pain- and emotion-regulating pathways share the same hormones, past traumas can sometimes manifest as future chronic pain, some people can be genetically predisposed to it, and in many cases the chronic pain is what gives rise to depression due to its impacts on quality of life. However, pain and mental health are inextricably linked in that affecting one will affect the other, which occurs in both negative and positive directions. And the connection is not just abstract; as an example, depression may decrease one’s motivation to stay physically active, which causes muscle weakening and eventually atrophy. This then places further strain on joints and muscles. Another example is that of pain regulation requiring serotonin and dopamine, which depletes these neurotransmitters also involved in regulating mood.
Despite this information, this book also reminds us of the dangers of jumping to the mind-body conclusion—generally, patients do not enjoy being told that the pain is “in their head.” Falsely attributing chronic pain to unresolved disputes or past traumas can inadvertently alienate the patient and prevent a trusting relationship from being formed with their healthcare provider. Indeed, a multitude of factors are at play; there is evidence suggesting that patients who have a positive relationship with the healthcare provider treating their pain generally have greater improvements in pain outcomes following intervention compared to those who have negative relationships. There is a fine line between explaining to a patient that belief and an internal locus of control have been shown to measurably alleviate pain versus implying to them that they have simply made up their pain. Medications do help, but so does the mind. Having this tricky discussion makes the practice of medicine an art as much as it is a science.
In the end, there are indeed pockets of knowledge that are valuable to our understanding of chronic pain, but—perhaps impossible to achieve—we do not have a unifying theory for it. This book is full of seeming contradictions not due to poor writing, but due to the nature of chronic pain. The jumping from one argument to another and then back again represents how individual and variable the experience of chronic pain is. It is truly based on the person’s unique context; what helps one may not help another. Some might want to see their pain as a disease whereas others might want to see that there is actually nothing wrong with them. Some might want their doctors to identify and treat a specific physical cause whereas others might wish their doctors would approach their pain more holistically. Pain is multifaceted, to say the least—there is much content from the book that I have not mentioned in this review due to their sheer complexity, such as the role of religion and spirituality in the experience of pain. In those cases, people have managed to dissociate themselves from their pain through seeing it as a bridge between them and a greater purpose. It is unmistakable that members of several religions and cultural traditions have been able to find meaning in pain, and even experience a pain-free state with what would typically cause people significant pain. All of this goes to show that as much as the physiology of pain can be discovered and explained, it also cannot be. It is a deeply human experience that is intertwined with our identities and our ideas about what pain means to us.
June 16, 2020
This book was fascinating for me and I liked it more toward the end as she explained new methods for dealing with pain.
March 17, 2019
Just what I have expected! An awesome book about pain- a deep and hard one!
September 3, 2016
I began reading this book looking for hope. I was hoping to hear personal stories so I could know I'm not alone in this fight. I wanted to learn about the cutting-edge research being done at leading pain clinics across the country. I wanted to learn alternate coping methods. I also wanted to find ideas/methods to help my family understand what I go through & learn ways to help them cope with it as well.
I started & stopped reading many times. I forced myself to keep reading until I found some sort of comfort. The comfort & hope didn't come & I eventually stopped reading altogether. In my opinion, I never thought she captured anything even close to what I suffer through each & every day. Maybe one day I will pick this book back up, finish it & see things differently.
I agree with Jeanette's review below from March 2011:
"I just don't have it in me to write a proper review of this book. I can't do it objectively, and I'm not in the mood to rant. Not much of a ranter even in the worst of circumstances.
If, like me, you're a chronic pain sufferer whose life has been defined and limited by your condition, you're not likely to find the book comforting or helpful. It's more likely to frustrate or anger you. If you are fortunate enough to be pain-free and want to study pain as a purely intellectual exercise, The Pain Chronicles may interest you.
The author herself claims to be among those with real chronic pain, but it's clear from the way she writes so coldly and clinically about the subject that she only THINKS she knows what it's like. We who live with it as a permanent, unrelenting condition could never write a book like this. It would come across as a self-pitying, sympathy-grubbing whine festival.
So, in the interest of fairness, because she was willing to write about pain studies, I can give Thernstrom two stars instead of one. Maybe the book will have some value in building a general understanding of pain and the various attempts to alleviate it. Just don't go into it looking for anything that will ease your own experience of pain.
If you live with pain as a constant, unremitting companion, you don't want science. You want to know how can I make it go away, or at least let up, for an hour, or even a few minutes? For that, I recommend books and CDs teaching breathing techniques. Andrew Weil and Jon Kabat-Zinn are especially good.
I started & stopped reading many times. I forced myself to keep reading until I found some sort of comfort. The comfort & hope didn't come & I eventually stopped reading altogether. In my opinion, I never thought she captured anything even close to what I suffer through each & every day. Maybe one day I will pick this book back up, finish it & see things differently.
I agree with Jeanette's review below from March 2011:
"I just don't have it in me to write a proper review of this book. I can't do it objectively, and I'm not in the mood to rant. Not much of a ranter even in the worst of circumstances.
If, like me, you're a chronic pain sufferer whose life has been defined and limited by your condition, you're not likely to find the book comforting or helpful. It's more likely to frustrate or anger you. If you are fortunate enough to be pain-free and want to study pain as a purely intellectual exercise, The Pain Chronicles may interest you.
The author herself claims to be among those with real chronic pain, but it's clear from the way she writes so coldly and clinically about the subject that she only THINKS she knows what it's like. We who live with it as a permanent, unrelenting condition could never write a book like this. It would come across as a self-pitying, sympathy-grubbing whine festival.
So, in the interest of fairness, because she was willing to write about pain studies, I can give Thernstrom two stars instead of one. Maybe the book will have some value in building a general understanding of pain and the various attempts to alleviate it. Just don't go into it looking for anything that will ease your own experience of pain.
If you live with pain as a constant, unremitting companion, you don't want science. You want to know how can I make it go away, or at least let up, for an hour, or even a few minutes? For that, I recommend books and CDs teaching breathing techniques. Andrew Weil and Jon Kabat-Zinn are especially good.
September 7, 2014
It wasn't long ago that scientists believed 'animals don't feel pain.' This benighted statement was roundly disproved, of course. But the same kind of arrogant, ignorant, self-important, mewling idiocy ruined this book for me.
Ms. Thernstrom bleats her opinion that animals don't suffer as humans do. That only the almighty human animal is capable of questioning the reasons for the pain inflicted on it. So, where in hell does this writer get the idea that she knows what animals think? Experience? Suffer? In the same vein, she claims that multiple millennium ago the supremely superior human animal felt suffering above and beyond any other inhabitant of the planet. Really? Did you do some kind of magic time travel and soul-transmigration to be able to state that so definitively?
This book and its author don't deserve any more of my time.
But the writer DOES deserve all the pain she so proudly claims. I only wish for one thing from her: suffer in silence.
Ms. Thernstrom bleats her opinion that animals don't suffer as humans do. That only the almighty human animal is capable of questioning the reasons for the pain inflicted on it. So, where in hell does this writer get the idea that she knows what animals think? Experience? Suffer? In the same vein, she claims that multiple millennium ago the supremely superior human animal felt suffering above and beyond any other inhabitant of the planet. Really? Did you do some kind of magic time travel and soul-transmigration to be able to state that so definitively?
This book and its author don't deserve any more of my time.
But the writer DOES deserve all the pain she so proudly claims. I only wish for one thing from her: suffer in silence.
July 3, 2020
I have seen some reviews from chronic pain sufferers on here that they were disappointed in this book, because they found it unhelpful for their condition. This, however, is a book that explores and presents historical cultural contexts of pain and current medical research on pain. It is not intended as a book to help people deal with chronic pain; Thernstrom is not a doctor, therapist, or scientist. She is a journalist, and she is reporting on the subject of pain. In that, I believe she does very well. I learned a lot about the body, the mind, medicine, and culture with this book. Thernstrom happens to experience chronic pain, and she interviews several people who do as well, but these stories are presented largely as illustrations of approaches to pain rather than the purpose of the book. I think as long as a reader approaches this book realizing it is scientific reportage and not medical or spiritual advice, then they could find this book quite interesting.
June 13, 2013
Info was useful in many ways but author spent too much time (for me) in her head, waiting what seemed to be too long to get her own diagnosis and then withholding it from the reader. The basic gist is lots of research is going on but the way we treat pain (massage, physical therapy, shots, surgery) will not markedly change in the near future. What may change unfortunately (from the research of brain imaging) is another way for insurance companies to deny treatment. Fun fun.
September 14, 2010
Author Melanie Thernstrom knows pain, and intersperses her personal experience as a chronic sufferer while she shares medical, historical, and cultural information on the topic of pain. I especially appreciated her ability to describe the complexitities of the body and brain. A fascinating book.
April 9, 2012
May or may not be a good read for people with chronic pain. But I do think it would be useful for people who have someone in their lives who suffers chronic pain.
This is part memoir of the author's pain, part quick biology lesson, and part cultural history of pain.
This is part memoir of the author's pain, part quick biology lesson, and part cultural history of pain.
October 20, 2012
Muy interesante ensayo/conjunto de crónicas a propósito del dolor y de cómo la enfermedad puede afectar a nuestro ánimo. La voz de Melanie T es a veces demasiado afectada, pero sabe tomarse con distancia y con humor estos temas.
Currently reading
September 25, 2012Been having trouble finishing this book myself. In reading the previous reviews, most chronic pain patients are! I feel so much better wondering why I wasn't "getting" it from this author. Maybe she doesn't get it!
February 22, 2011
Really interesting... If a little esoteric. Probably wouldn't recommend it to anyone who doesn't suffer from chronic pain (or love someone who does).
August 1, 2018
We all experience physical pain in our lives, some chronic pain. I have been fortunate enough for the most part not have had to deal with the daily chronic type. But if we live long enough that is more likely. Today the focus is very much on pain relief and the resultant opioid addiction we see so much in the news.
In this book, which I listened to as audio Melanie Ternstrom discusses and picks apart at length her life experience with pain that stemmed from her shoulder. It is much discussion and probing into the many aspects of pain, yet we really don't get a sense of the degree of the pain or answers or cures for it. Much discussion and pondering is what is offered.
It was clearly apparent to me in concluding the book there are no concrete answers and many variations. It is also clear to me that we are still very much in the dark ages of understanding, managing, or curing pain. Despite our perceived super medical technology we still pretty much are clueless and impotent in conquering pain. Eons from now maybe a different scenario, but not for now.
In this book, which I listened to as audio Melanie Ternstrom discusses and picks apart at length her life experience with pain that stemmed from her shoulder. It is much discussion and probing into the many aspects of pain, yet we really don't get a sense of the degree of the pain or answers or cures for it. Much discussion and pondering is what is offered.
It was clearly apparent to me in concluding the book there are no concrete answers and many variations. It is also clear to me that we are still very much in the dark ages of understanding, managing, or curing pain. Despite our perceived super medical technology we still pretty much are clueless and impotent in conquering pain. Eons from now maybe a different scenario, but not for now.
September 22, 2024
It was an OKAY read from a historical perspective.
The book was heavily focused on medicine and because of doctors lack of knowledge around nutritional value on chronic and degenerative diseases (information I’ve attained from other books), I largely disagree with much of the information shared.
Additionally, since the book was written in 2010, it lacked anything about trauma and how integenerational trauma and malnutrition and the like, can then lead to degenerative disease, chronic pain and so forth.
Would I recommend you to read the book?
Only if you’re interested. It’s not the worst read, it’s not the best read.
I’d much higher recommend either “Body keeps the score” by Bessel Van Der Kolk … or “Breaking the habit of being yourself” by Dr Joe Dispenza. Additionally reading “what your doctor doesn’t know about nutritional health may be killing you” by Ray D Strand MD.
I just happen to know many other ways to address pain (which have helped those who are in pain), that this book doesn’t even touch on.
The book was heavily focused on medicine and because of doctors lack of knowledge around nutritional value on chronic and degenerative diseases (information I’ve attained from other books), I largely disagree with much of the information shared.
Additionally, since the book was written in 2010, it lacked anything about trauma and how integenerational trauma and malnutrition and the like, can then lead to degenerative disease, chronic pain and so forth.
Would I recommend you to read the book?
Only if you’re interested. It’s not the worst read, it’s not the best read.
I’d much higher recommend either “Body keeps the score” by Bessel Van Der Kolk … or “Breaking the habit of being yourself” by Dr Joe Dispenza. Additionally reading “what your doctor doesn’t know about nutritional health may be killing you” by Ray D Strand MD.
I just happen to know many other ways to address pain (which have helped those who are in pain), that this book doesn’t even touch on.
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