We assume that our ancestors felt pain in much the same way as we do today. But perhaps this ‘common-sense’ assumption is incorrect. The way individuals relate to the world, including their own bodies, is interpreted through culture, there is no such thing as an unmediated experience. The only way to make sense of the potentially overwhelming and chaotic nature of experiential reality is via reference to learnt, culturally specific narratives and metaphoric tropes. As culture is dynamic and develops in response to many factors the experience of feeling and comprehending pain changes over time.
It is a truism that pain antedates human history, animals may be devoid of conscience but they clearly react to physical pain. Pain is a part of everybody’s personal experience: it is a common yet elusive phenomenon. It is possible to quantify the human body’s neurological reaction to stress but pain cannot be objectively measured as its a phenomenon that can only ever be described (and experienced) in qualitative terms. We can never be sure that others experience pain as we do: empathy has its limitations. Most people associate the sensation of pain with a dis-functioning part of the body brought on by injury or disease, or a mental pain caused by experiencing some form of sadness, such as the loss of a loved one. The western philosophical tradition radically separates material entities (the body) from the immaterial (the psyche), yet to insist on distinguishing physical pain from mental anguish is, to a large extent, to impose a false dichotomy. Clinicians know little of the mechanisms of psychosomatic illness (yet few would deny the existence of this ‘strange’ phenomenon) and debilitating physical conditions are commonly accompanied by bouts of depression. The physical and psychic realms are interconnected in ways we intuitively understand, yet are unable to account for scientifically.
Most would agree that pain is perhaps difficult to render in language, as is any intensely experienced human emotion, whether it is pleasurable or tortuous. Poetry, with its inherent ambiguity and intensity provides a potentially appropriate medium for the consideration of pain. Emily Dickinson wrote the poem ‘pain has an element of blank’ in the mid-nineteenth century.
Pain has an element of blank;
It cannot recollect
When it began, or if there was
A time when it was not.
It has no future but itself,
Its infinite realms contain
Its past, enlightened to perceive
New periods of pain.
Dickinson is clearly invoking the seemingly eternal (‘It cannot recollect/ When it began, or if there was/ A time when it was not’) and domineering (‘its infinite realms’) nature of intense pain. One could easily read the ‘element of blank’ as invoking the notion of the difficulty in expressing pain at all: one has the image of the poet staring at a blank page trying to summon the linguistic tools to represent this nebulous concept. Dickinson’s work itself eloquently demonstrates that it is possible to represent pain in language, her poetry is replete with references to pain and suffering. In our contemporary culture we are used to the concept of pain as being a fundamentally subjective category, communication is by definition inter-subjective, therefore conveying pain is potentially problematic. Communicating pain to loved ones or companions is in some respects easier than discussing it with strangers or those in positions of relative power and authority~ for example, members of the medical profession~ due to mutual understanding of shared cultural reference points. On the other hand, individuals experiencing pain are often keen to protect emotionally significant others from knowledge of the anguish they are enduring. When examining testimonies of pain the context and circumstances in which they were produced must remain in the forefront of our minds.
Pain has always played a number of very significant roles in Christian thought. The suffering of Christ on the cross is, of course, the source of all mankind’s redemption. Mortification, self-imposed hardship and pain, was recognized for centuries as a means of controlling desire and passion. In traditional Christian narratives suffering on earth was infinitely better than enduring the abjections of hell. Pain could be edifying, instructive and devotional. Pain could also be interpreted as the will or punishment of a censorious God. In orthodox Christianity pain was both ‘sanctified and reformatory’ Historians have suggested that throughout modern history Christian thought and teaching concerning pain underwent a significant shift. The vengeful and cruel God of the Old Testament was displaced in favour of a more benign and enlightened deity. In Britain belief in the existence of extreme physical pain in hell diminished. As a consequence the importance of Christianity as a framing device for understanding physical suffering waned.
Ann Dally has written that in the early nineteenth century “the idea of the ubiquity of sickness, death and woe had been prevalent for many centuries and was reinforced by Christian ideas of original sin.” However, from the mid-nineteenth century onwards the inevitability of one particular woe, pain, became challenged. The development of increasingly effective analgesics throughout the century, from the separation of morphine from opium in 1806 to the production of aspirin in 1899, meant that pain could be managed and the notion that pain may one day be completely eradicated became culturally current. The arrival of the use of anesthesia in surgical procedures meant that for the first time surgery was no longer necessarily the treatment of last resort. Ether, was used for the first time in England in 1846 and widespread trials immediately followed. The use of chloroform followed rapidly in 1847. It has been suggested that by the 1860s there had been a clear shift… and anaesthesia was established as an integral part of the surgical experience. Increasingly the belief that pain served no physiological function and that in the surgical context, pain and suffering were purposeless and often dangerous began to become dominant.
Dally suggested that there was resistance to the idea of relieving pain. This was largely moral and religious and reached its peak later in the nineteenth century over the question of the relief of pain in childbirth. However, many hospitals in England had appointed anaesthetists before 1900 and palliative medicine has become increasingly sophisticated over the last 150 years. New technologies and discursive practices created new possibilities for organizing one’s experience of the world: thick description declines in importance as a diagnostic tool. Pain was no longer considered an inevitable aspect of life if by the 1840s one of the primary duties of doctors was to relieve pain and suffering, it is perhaps reasonable to suggest that today many clinicians and patients consider the eradication of pain to be absolutely essential, this belief has become so ubiquitous that it barely warrants articulating.
In contrast, the narrative description of “A Mastectomy at the hands of Baron Larrey conducted on the 30th September 1811” Fanny Burney wrote ““Yet—when the dreadful steel was plunged into the breast—cutting through veins—arteries—flesh—nerves—I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision—and I almost marvel that it rings not in my Ears still! so excruciating was the agony. When the wound was made, and the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp and forked poniards, that were tearing the edges of the wound—but when again I felt the instrument—describing a curve—cutting against the grain…I thought I must have expired.”!”
Eighty-one years later in his diary record of a surgical procedure for the treatment of a fracture of the patella conducted at Guy’s hospital, G H Crosby writes “the India rubber bag was passed under my nose… Then I knew no more, dropped off, lost my feelings (sweet sounds of bells). Knew nothing more until I woke about 6.20”. The “rackling” and “scraping” endured by Fanny Burney had been replaced by the “sweet sound of bells” experienced by Crosby.
Pain does indeed have an ‘element of blank’, in that it is essentially meaningless in itself. Conceptions of pain underwent radical change throughout the nineteenth century. The fundamental ‘blankness’ of pain render it a perfect screen upon which individuals and societies project significance, significance which is always conditional, precarious and open to challenge.
Bending, Lucy. 2000. The Representation of Bodily Pain in Late Nineteenth-Century English Culture. Oxford: Oxford University Press.
Bending, Lucy. 2006. “Approximation, Suggestion, and Analogy: Translating Pain into Language.” The Yearbook of English Studies 36, No 1. Translation: 131-137.
Bourke, Joanna. 2011. Pain and the Politics of Sympathy, Historical Reflections, 1760s to 1960s. Utrecht: Universiteit Utrecht.
Burney, Francis. 1986. Journals and Letters. London: Penguin Classics.
Dally, Ann. 1991. Women Under the Knife: A History of Surgery. London: Hutchinson Radius.
Dickinson , Emily. 1961. The Complete Poems of Emily Dickinson. Edited by Johnson, Thomas H. New York NY: Little Brown and Company.
Dormandy, Thomas. 2006. The Worst of Evils: The Fight Against Pain. New Haven and London: Yale University Press, 2006.
Mangion, Carmen M. 2012 “‘Why, would you have me live upon a gridiron?’: Pain in Nineteenth-Century English Convent Narratives.” Interdisciplinary Studies in the Long Nineteenth Century 15.
Scarry, Elaine. 1985. The Body in Pain. The Making and Unmaking of the World. New York, NY: Oxford University Press.
Snow, Stephanie J. 2006. Operations without Pain: The Practice and Science of Anaesthesia in Victorian Britain. Hampshire: Palgrave Macmillan.
Patient Diary of G. H. Crosby kept from Dec 14th 1892 to March 1893. Held at the Gordon Museum Guy’s Hospital. Curator Bill Edwards.
To cite this post : Julie Mathias, “’Pain has an element of blank’’”, Museum Highlights (blog on oldoperatingtheatre.com), August 30th, 2016.
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Julie Mathias is the Head of Learning at the Old Operating Theatre Museum and Herb Garret. Her role includes convening the schools programs for students studying the “Medicine Through Time” series and related subjects. As a social historian Julie is interested in the history of ‘ordinary’ peoples’ experiences of health, illness, and death, and how investigating this fascinating phenomena enriches our present day understanding of our own bodies.