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Authors: Keith Wailoo

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48
. For minorities' pain, see, for example, Benny J. Primm et al., “Managing Pain: The Challenge in Underserved Populations,”
Journal of the National Medical Association
96 (September 2004): 1152–61; for more on race and the politics of pain, see Wailoo,
Dying in the City of the Blues
; for Knox Todd, see Knox Todd, Tony Lee, and Jerome Hoffman, “The Effect of Ethnicity on Physician Estimates of Pain Severity in Patients with Isolated Extremity Trauma,”
Journal of the American Medical Association
271, no. 12 (March 23, 1994); for Atlanta disparities, see Todd et al., “The Effect of Ethnicity”; and Cleeland et al., “Pain and Its Treatment in Outpatients.”

49
. The trend persisted; a 2003 study found the same “racial and ethnic disparities in emergency department analgesic prescription.” J. H. Tamayo-Sarver et al., “Racial and Ethnic Disparities in Emergency Department Analgesic Prescription,”
American Journal of Public Health
93 (2003): 2067–73; for “inadequate prescribing …,” see Charles Cleeland, Rene Gonin, Luis Baez, Patrick Loehrer, and Kishan Pandya, “Pain and Treatment of Pain in Minority Patients with Cancer: The Eastern Cooperative Oncology Group Minority Outpatient Pain Study,”
Annals of Internal Medicine
127, no. 9 (November 1, 1997): 813–16.

50
. For “major public health problem,” see
Summary of the Capitol Hill Breakfast Briefing on Pain Management
, sponsored by the Honorable Tom Harkin, May 7, 1997,
www.docstoc.com/docs/48489459/Pain-Management
; for gender difference, see Diane E. Hoffmann and Anita J. Tarzian, “The Girl Who Cried Pain: A Bias against Women in the Treatment of Pain,”
Journal of Law, Medicine, and Ethics
29 (2001): 13–27; Nancy Wartik, “Hurting More, Helped Less?”
New York Times
, June 23, 2002, M1; Christine Miaskowski, “Women and Pain,”
Critical Care Nursing Clinics of North America
9 (1997): 453–58; for “more inclined than men …,” see Peg Rosen, “The Pain Truth,”
Good Housekeeping
, May 2003, 83–84, 86, 88.

51
. For an example of this attitude from the 1920s, see E. Libman, “Observations on Sensitiveness to Pain,”
Transactions of the Association of American Physicians
41 (1926): 305. Libman pronounced that “prizefighters, Negroes, and American Indians, as groups, failed to react to noxious stimuli of intensity great enough to induce reaction of discomfort in the average white city dweller.”

52
. Morrison et al., “‘We Don't Carry That.'”

53
. For “one of the saddest …,” see Drug Reform Coalition Network, “War on Pain Control,”
Activist Guide
(October 26, 1996); for costs, see
Summary of the Capitol Hill Breakfast Briefing on Pain Management
, sponsored by the Honorable Tom Harkin (May 7, 1997); for “pain is our nation's …,” see Ronald Carson, “Drugs and Pain,”
Washington Post
, August 21, 1998, A23; see also “Nickles Introduces Pain Relief Promotion Act” (press release), June 17, 1999
www.gpo.gov/fdsys/pkg/BILLS-106s1272is/pdf/BILLS-106s1272is.pdf
; see also Ron Wyden, Gordon Smith, and Darlene Hooley's legislation reintroducing the Conquering Pain Act, June 13, 2001,
www.govtrack.us/congress/bills/108/s1278/text
; A. Meisel, L. Snyder, and T. Quill, “Seven Legal Barriers to End-of-Life Care: Myths, Realities, and Grains of Truth,”
Journal of the American Medical Association
284 (2000): 2483–88. See Stephen J. Ziegler and Nicholas P. Lovrich Jr., “Pain Relief, Prescription Drugs, and Prosecution: A Four-State Survey of Chief Prosecutors,”
Journal of Law, Medicine, and Ethics
31 (2003): 75–100.

54
. For “in such cases …,” see Christine L. Pasero and Peggy Compton, “Pain Control: When Does Drug-Seeking Behavior Signal Addiction?”
American Journal of Nursing
97 (May 1997): 17–18; D. E. Weissman and J. D. Haddox, “Opioid Pseudoaddiction,”
Pain
36 (1989): 363–66; see also A. Hegarty and R. K. Portenoy, “Pharmacotherapy of Neuropathic Pain,”
Seminars in Neurology
14, no. 3 (1994): 213–24; for new theory of pain behavior, see Knox H. Todd, “Chronic Pain and Aberrant Drug-Related Behavior in the Emergency Department,”
Journal of Law, Medicine, and Ethics
(Winter 2005): 761–69.

55
. For “pill mills,” see Bob LeMendola and Larry Lebowitz, “Doctor Pushed Pills, Agents Say at Least 8 Patients Died,”
Ft. Lauderdale Sun Sentinel
, April 2, 1999, 1A; Jennifer C. Kerr, “Bush Anti-Drug Plan Targets Painkillers,”
Cincinnati Post
, March 1, 2004, A1; on new hospital regulations, Barbara Acello, “Meeting JCAHO standards for pain control,”
Nursing
30 (March 2000): 52; “JCAHO Begins Surveying for New Pain Standards,”
Hospital Peer Review
25 (May 2000): 67–68; “JCAHO Publishes Pain Assessment and Management: An Organizational Approach,”
Journal of Clinical Engineering
25 (July–August 2000): 199; D. M. Phillips, “JCAHO Pain Management Standards Are Unveiled. Joint Commission on Accreditation of Healthcare Organizations,”
Journal of the American Medical Association
284 (July 26, 2000): 428–29; Susan Okie, “New Medical Standard Brings Pain into Focus,”
Washington Post
, January 8, 2001, A3.

56
. On environment for Limbaugh's use, see Teresa Lane, “Alleged ‘Pill Mill' Leads to Charges,”
Palm Beach Post
, July 4, 2003, 1B; “Too Many Pills, Too Many Deaths,”
Palm Beach Post
, August 8, 2003, 16A; on Limbaugh's defense,
see “Judge Unseals Medical Records of Limbaugh,”
New York Times
, December 24, 2003.

57
. Harris Gardiner, “FDA to Place New Limits on Prescription of Narcotics,”
New York Times
, February 10, 2009, A13.

58
. For “more people than heroin …,” see Charles Ornstein and Tracy Weber, “Senate Panel Investigates Drug Companies' Ties to Pain Groups,”
Washington Post
, May 8, 2012; for “guides for patients …,” see letter to medical groups including Johnson and Johnson, Endo Pharmaceutical, American Pain Society, and others, from Sens. Baucus and Grassley Regarding Potential Ties of Opioid Manufacturers, May 8, 2012,
www.finance.senate.gov/newsroom/chairman/release/?id=021c94cd-b93e-4e4e-bcf4-7f4b9fae0047
. As the committee saw the matter, the country was experiencing “an epidemic of accidental deaths and addiction resulting from the sale and use of powerful narcotic painkillers such as Oxycontin (oxycodone), Vicodin (hydrocodone), and Opana (oxymorphone). According to CDC data, ‘more than 40% (14,800)' of the ‘36,500 drug poisoning deaths in 2008' were related to opioid-based prescription painkillers.” Peter Whoriskey, “The Prescription Painkiller Binge,”
Washington Post
, December 31, 2012, A1.

59
. For “powerful voice …,” see Clarence Page, “Call for Treatment Instead of Jail,”
Chicago Tribune
, November 19, 2003, 29; for “the Democrats still cannot …,” see “Judge Unseals Medical Files of Limbaugh,”
New York Times
, December 24, 2003, A18.

60
. Ben Fishel, “Confronted by Caller, Limbaugh Denied Any Similarity between His OxyContin Issue and Kennedy's ‘Cover Up,'”
MediaMatters
, May 8, 2006,
http://mediamatters.org/research/200605080015
.

Conclusion: Theaters of Compassion

1
. Javier Moscoso,
Pain: A Cultural History
(New York: Palgrave MacMillan, 2012), 43.

2
. Talal Asad,
Formations of the Secular: Christianity, Islam, Modernity
(Stanford, CA: Stanford University Press, 2003), 4.

3
. Daniel T. Rodgers,
Contested Truths: Keywords in American Politics since Independence
(New York: Basic Books, 1987), 10.

4
. Sara Dubow,
Ourselves Unborn: A History of the Fetus in Modern America
(New York: Oxford University Press, 2011).

5
. See Unborn Child Pain Awareness Act, S. 356 and H.R. 3442.

6
. New Jersey Compassionate Use Medical Marijuana Act, January 11, 2010. See also “Marijuana and Medicine: Assessing the Science Base—a Summary of the 1999 Institute of Medicine Report,”
Archives of General Psychiatry
(June 2000).

7
. This section of the conclusion expands on a previously published essay. Keith Wailoo, “Can Reform Spell Relief?”
American Prospect
, July 2010.

8
. The Patient Protection and Affordable Care Act (2010), 466,
www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf
.

9
. Robert Pear, “Expecting Presidential Veto, Senate Passes Child Health Measure,”
New York Times
, November 2, 2007, A23.

10
. For two models of how morality and religion intersect with the political Left and Right in America, see James A. Marone,
Hellfire Nation: The Politics of Sin in American History
(New Haven, CT: Yale University Press, 2003); and George Lakoff,
Moral Politics: How Liberals and Conservatives Think
(Chicago: University of Chicago Press, 2002).

11
. “Congressman Mike Rogers' Opening Statement on Health Care Reform,” YouTube video, posted by RepMikeRogers on July 16, 2009,
www.youtube.com/watch?feature=player_embedded&v=G44NCvNDLfc
.

12
. Committee on Advancing Pain Research, Care and Education, Institute of Medicine,
Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research
(Washington, D.C: National Academies Press, 2011), x. See also R. Gallagher, “What Should All Physicians Know about Pain Medicine? Workgroup Report, the First National Pain Medicine Summit—Final Summary Report,”
Pain Medicine
11:1450–52.

13
.
Relieving Pain in America
, xii.

14
. Eric Lichtblau, “Economic Slide Took a Detour at Capitol Hill,”
New York Times
, December 27, 2011, 1.

15
. “Pain and Disability: Clinical, Behavioral, and Public Policy Perspectives; Report on the Commission of the Evaluation of Pain,”
Social Security Bulletin
50, no. 1 (January 1987): 22.

16
. Asad,
Formations of the Secular
, 83.

Index

Page numbers in
italic
indicate figures.

abortion and “fetal pain,”
123
–25,
128
,
140
,
150
,
160
,
205
–6

ACA (Affordable Care Act, Obamacare),
208
,
210
–11

acupuncture therapy,
87
–93,
90
,
94

addiction: clock-watchers and,
137

controlled release and,
184

disability and,
100

fears of,
30
,
31
,
37
,
127
,
138

to heroin,
86

Kudlow and,
7

Limbaugh and,
6

lobotomy as cure for,
38

pain relief and,
141
,
142
,
211

OxyContin and,
168
–71,
183
–86,
187
,
189
,
194
,
201

pseudoaddiction,
198
,
207

Adkins, Janet,
131
,
132
,
133
,
146

affluence,
30

Affordable Care Act (ACA, Obamacare),
208
,
210
–11

African Americans,
8
,
48
–49,
61
,
68
–69,
87
,
195
–96

AIDS,
7
,
125
–26,
151
,
173
,
180
,
209

Albronda, Henry,
49
,
50
,
53
,
54
–55

Aldrich, Bailey,
97

Altemeier, William,
56

“alternative” remedies,
80
–81,
87
–93

Altmeyer, Arthur,
21
–22

AMA.
See
American Medical Association

American Academy of Pain Medicine,
200

American Legion,
14
,
18
,
26
,
47

American Medical Association (AMA): conservative outlook of,
4
,
18
,
136

Eisenhower administration and,
23
–24

government intervention into health care and,
166
–67

Orr and,
13

PAS and,
156

perceptions of pain and disability by,
18

SSDI and,
45
,
46
–47

Texas reform and,
138

veterans' benefits and,
20
–21,
22

veterans' groups and,
25
–26

American Pain Foundation,
200

American Pain Society,
200

analgesia: management of pain through,
34
,
86

patient-controlled,
95
,
133

Annas, George,
180

Arnett, Dixon,
139

arthritis: arthritic personality,
55
–56

Cox-2 inhibitors for,
183

ibuprofen for,
172

Oraflex for,
173
–76,
179

pain and,
9
,
22
,
40
,
51
–60,
69
–74,
125
,
127
,
151
,
190
,
192
,
210

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