The Pain Chronicles (8 page)

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Authors: Melanie Thernstrom

Tags: #General, #Psychology, #History, #Nursing, #Medical, #Health & Fitness, #Personal Narratives, #Popular works, #Chronic Disease - psychology, #Pain Management, #pain, #Family & Health: General, #Chronic Disease, #Popular medicine & health, #Pain - psychology, #etiology, #Pain (Medical Aspects), #Chronic Disease - therapy, #Pain - therapy, #Pain - etiology, #Pain Medicine

BOOK: The Pain Chronicles
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JESUS’ PAIN

The conception of pain and suffering in Jewish and Christian scripture had implications for medicine that were profoundly different from those in the theology of magic-based religions. In the latter, the right magical formula could eradicate a fever-causing demon as surely as the right plant leaves could ease a fever. The spell targeted an underlying supernatural cause, whereas the potion treated its manifestation in the natural world, but both had the same result.
Magic is effective together with medicine. Medicine is effective together with magic.
Replacing magical practices with religious ones, however, called for a more complicated internal response of repentance and prayer. This followed from the biblical premise that God cannot be manipulated through incantations or herbs to serve human desires (although God can play an opaque role in healing: paradoxically, once Job humbles himself, God restores his health).

The New Testament departs radically from Judaism here. Christianity promises the faithful not physical health, but spiritual salvation—goals that are aligned in Judaism but actually
opposed
in Jesus’ story. Egyptian and Greek medical remedies imitated the gods’ remedies for the successful assuaging of their pains. The Christian ideal of imitating Christ,
imitatio Christi
, stands in contrast. Unlike Horus, who is rescued from the headache-causing catfish demon, Christ is not freed from the pain of crucifixion. Rather, he suffers unto death, showing Christians not how to evade pain, but how to welcome its redemptive possibilities.

The canonical Gospels don’t describe Jesus’ pain during the crucifixion, although the Gospel of Saint Peter, one of the Gnostic Gospels, contrasts Jesus with the thieves being crucified by his side, saying he “was silent as one who experiences no pain.” But mainstream Christian theology asserts that Jesus did suffer pain; that to be fully human he had to do so; and that in doing so, he paid the price for humanity’s redemption. (After all, how much of a sacrifice is it for an immortal merely to painlessly shed the human body he temporarily inhabited and reassume his place in heaven?)

Jesus suffered in what can be described as a peculiarly human way: torture by crucifixion is designed to take advantage of pain-sensing capacities specific to human anatomy. The universal eloquence of wounds to the hands and feet—the instinctive horror an image of them evokes—derives from the evolutionary importance of those parts and their consequential ability to feel pain.

Since the human palm is not substantial enough to support the weight of a human’s body on a cross without the nails tearing out, some historians argue that nails were driven either through Jesus’ wrists, where they would have been held in place by carpal bones, or between the radius and ulna bones in his forearm, as is consistent with the one extant skeleton of a man crucified in that period. Regardless, nails through either the wrists or the hands would damage the median nerves that supply the hands, causing excruciating pain (from the Latin
cruciare
, “to torment, crucify”). The pain of carpal tunnel syndrome can come as a result of the median nerves merely being compressed by surrounding tissue.

Body parts are protected by nerves in proportion to their importance for survival. A cut to the lips, hands, or testicles—or the nerve branches that supply them—hurts more than a cut to the back or arm, where a wound is less likely to threaten a vital function. Wrapping around the top of the human brain is an area known as the sensory cortex, which functions as a map of the body and its sensations. Information coming from the sensory nerves is registered by the corresponding parts of this map: input from the hands is mapped to the hand regions of the sensory cortex. This cortical map is sometimes referred to as the
sensory homunculus
(Latin for “little man”). It can be thought of as “the body in the brain.” Thus, although we may experience pain as coming from our hands, what actually hurts are the hands of the homunculus.

Since the parts of this body represent the actual body in proportion to the nerves it contains, rather than to its actual size, the homunculus has a giant head with swollen lips and tongue, large genitals, massive hands with big fingers and a giant thumb, and feet with ballooning toes. Human hands are so dense with nerves that a homunculus’s hands are bigger than the entire trunk of its body! Artistic depictions of the crucifixion in which Jesus’ hands, feet, and face are exaggerated can be thought of as renderings of a homunculus, rather than of a body, and are therefore truer to our experience of our bodies.

THE MARTYR’S PARADOX

The idea of pain as spiritual transformation offends me. It seems, in a word, perverse. Pain is useless to the pained, the Greek physician Galen said (
dolor dolentibus inutilis est
), and almost everyone today decidedly agrees. If we try to describe the particular terror of pain, it seems to lie in the way that it kidnaps consciousness, annihilating the ordinary self. Yet many religious traditions insist that this terrible annihilation opens the possibility of self-transcendence, since the self is, in many religions, what separates us from the divine. Pain is an “alchemy of the soul”—melting, purifying, and reshaping sin. Pain is a means of devotion central to ascetic traditions. Its devotees range from self-flagellating Christians and Shi’ites to Muslims who wage internal jihad against the raging ego of the sinful self. Certain painful meditation methods of Yogis (involving icy water or holding uncomfortable positions for long periods of time) are said to strengthen the spirit as well as the body. The training of shamans typically involves painful rites.

Religions find so many uses for pain! It can be a payment for sin, preempting the even-worse pain of the afterlife. The medieval Christian theologian Thomas à Kempis advised that it is better “to suffer little things now that you may not have to suffer greater ones in eternity. If you can suffer only a little now, how will you be able to endure eternal torment?” In some religions, pain can be a penalty not only for one’s own sins but also for the sins of others. Self-inflicted pain in the Taoist tradition can not only atone for others, it can even rescue dead sinners who are already writhing in hell. In the Hindu and Buddhist karmic systems, pain can be a payment for transgressions from previous incarnations.

To embrace pain requires overcoming the most primal instincts. It requires privileging cultural beliefs (that pain may be desirable) over biological instincts (that it is always negative) and choosing a spiritual meaning that is normally overwhelmed by a corporeal one. Saints and martyrs are celebrated because they have achieved this unhuman or superhuman relationship to their own pain. Ironically, the bodies of saints are consecrated—and treasured in the form of relics—precisely because saints treat their bodies as something to discard.

In many traditions, martyrdom is the ultimate test of religious conviction, the most important opportunity for distinguishing the faithful from the apostates. In Hebrew, a term for martyrdom,
Kiddush Hashem
, means “sanctification of God’s name.” Martyrdom is the greatest act of
Kiddush Hashem.
For Christians, undergoing pain is the ultimate act of
imitatio Christi.
“Allow me to be eaten by the beasts, which are my way of reaching to God. I am God’s wheat, and I am to be ground by the teeth of wild beasts, so that I may become the pure bread of Christ,” wrote Saint Ignatius of Antioch in his second-century “Letter to the Romans.” His prayer was granted: the Romans fed him to the lions. (While praying for martyrdom was acceptable, seeking it out was not. Some would-be martyrs became frustrated by the Romans’ “don’t ask, don’t tell” policy toward Christians and turned themselves in for prosecution. But theological opinion determined that they were not virtuously withstanding martyrdom, but sinfully committing suicide.)

Yet how painful is willing pain? Do those who embrace suffering really suffer? Oddly, the ability to appear unaffected by torments seems central to the mythology of martyrs and saints—a mark of their special nature. While representations of sinners in hell show them writhing in torment, saints are usually pictured looking upward, their gaze sad and abstracted, such as Saint Sebastian, for whom being shot full of arrows seems only to have induced a deep reverie. “We pray you torment us further for we suffer not,” the brother physicians Cosmas and Damian legendarily implored their Roman torturers, who stoned them, drew them on a rack, and finally resorted to beheading them.

John Foxe’s beloved 1563
Book of Martyrs
relates with adulation how, when Bishop John Hooper was condemned to be burned alive, he praised God for the opportunity to demonstrate faith to his former flock. And demonstrate it he did—praying aloud to Jesus Christ as the flames consumed his body—in gruesome detail. He continued to pray “when he was black in the mouth, and his tongue so swollen that he could not speak, yet his lips went until they were shrunk to the gums.”

Yet, Foxe noted, he prayed “as one without pain.” Therein lies the paradox of martyrdom: its virtue lies in embracing pain, but that embrace seems to inure the martyr against the very pain that defines a martyr!

TRIAL BY ORDEAL

Personally, it was hard for me to take much inspiration from stories of the martyrs welcoming their pain, when my pain felt so unwelcome—forced upon me, I sometimes fancied, like the ancient practice of trial by ordeal that had fascinated me as a child.

In trial by ordeal, which flourished for thousands of years in cultures from ancient Mesopotamia, Greece, and India to Europe, the accused underwent a ritual in which—through magic or divine aid—guilt or innocence was established. In one type of ordeal, judges forced the accused to walk through flames or over hot plowshares for a certain distance, or to plunge his hands in boiling water or—worse—lead or oil. Astonishingly, betraying pain or injury constituted proof of guilt. In short, in order to prove their innocence, the accused had to show that they were protected from pain as martyr mythology insisted.

Sometimes signs of tissue damage itself were considered damning; in other instances, victims were permitted to suffer tissue damage as long as they maintained the equanimity of a martyr. In a form of trial by fire, the burns were inspected after three days, and if the wound persisted, the accused’s guilt was sealed. In short, the belief in pain as
poena
was so deeply rooted that suffering pain in and of itself
proved the sufferer deserving of
 poena.

Hindu law has specifically endorsed the fire ordeal. In the
Manusmriti
it is said, “When the blazing fire does not burn a man . . . he should be judged innocent.” In the Ordeal of the Bitter Water in the Jewish Torah, a woman suspected of adultery was forced to drink a concoction known as “bitter water” (which most scholars now believe was poisonous). If the drink caused her belly to swell—or, if, indeed, she perished—her guilt was established. In Europe, fire ordeals tended to be reserved for the upper class and water ordeals for commoners and witches. A famous eleventh-century English adultery case is typical. Queen Emma of Normandy was accused of committing adultery with the bishop of Winchester. When she walked absentmindedly over red-hot plowshares and asked when her trial would begin, she necessitated a finding in her favor.

In the early tenth century, King Athelstan of England codified the laws governing ordeals, decreeing that for one of the ordeals, the accused must pluck a stone from boiling water, submerging his or her hand up to the wrist or the elbow (depending on the severity of the accusation). The hands of the accused would then be bound and examined three days later. If the wounds were healing, the accused was deemed innocent, as God had healed them, but if the wounds were “foul,” the accused was condemned. Other types of ordeals involved games of chance such as jousting matches or drawing lots, with the idea that God would rig the games so that the innocent would win. A particularly nasty variety was the Babylonian river ordeal, in which guilt would be fatally assessed by the river deity after the accused was tossed into the rushing Euphrates.

In the thirteenth century, ordeals finally gave way to trial by jury (indeed, the jury system is thought to have been invented partly in response to the pressure of growing skepticism about the ordeal). Torture-provoked confession remained routine long after the demise of the ordeal, and some scholars argue that it was practiced in good faith, so to speak. From a modern perspective (recent events in American history notwithstanding), torture seems obviously flawed as a means of discerning guilt; indeed, the very fact of coercion seems to discredit the information it elicits. Yet according to a worldview that sanctified pain, torture was believed to enlighten not only the torturer but his victim as well. “The witch is executed in an exceptionally painful manner because her death is conceived, obscenely to be sure, as spiritual passage, initiatory rite, or saving violence, not merely a removal from society,” Ariel Glucklich writes in his extraordinary book
Sacred Pain.
Mercy for the witch would have been misdirected because it was the witchcraft, not the woman, that was being burned out or boiled away, in a terrible baptism of sorts. The woman was being redeemed as pain performed its fearful alchemy.

Pain Diary:

I Decide to Get a Diagnosis

“What are you doing at the moment?”
“I’m in pain.”
—Daudet

“Pain strengthens the religious person’s bond with God and other persons,” Ariel Glucklich writes in
Sacred Pain.
“Of course, since not all pain is voluntary or self-inflicted,” he adds helpfully, “one mystery of the religious life is how unwanted suffering can become transformed into sacred pain.”

A mystery, to be sure. The ancient religious traditions of self-inflicted pain still linger in some corners of the contemporary world. They flourish in the Philippine celebrations of Easter, where each year volunteers are nailed to crosses before enthusiastic crowds, and in the Hindu festival of Thaipusam in India and Malaysia, when pilgrims regularly mortify their flesh—hanging weighted fishhooks from their chests or threading skewers through their cheeks and tongues—and say they feel no pain. I had seen gruesome photographs of the mutilated flesh and serene faces. But what did any of it have to do with me?

Crossing the street against the light one day in Providence, where I was visiting Kurt, I found myself caught on the traffic island. The day was unusually hot. It struck me how different that heat on my neck—just the other side of pleasant—was from the sensation
in
my neck, which burned in a different way, like the scald of dry ice. How odd it was that the world outside my body no longer seemed to come inside it! The day did not melt the dry ice and ease my pain into the ordinary crankiness of August on the East Coast.

With cars crisscrossing in both directions, the city shimmered as if it were not a familiar, but an allegorical landscape in a story, a movie, or a dream. What if I was not in pain, but in Pain: a large, busy city filled with other unfortunates, next door to Samara. If I were in Pain, what should I do?

Take up your cross.

I was surprised to find the phrase surface in my mind, because I’ve never really understood it. The idea made my brain feel fuzzy.

Take up your cross and follow Me.

Uhh . . . What cross was that? Most of the time I feared I was insufficiently committed to being happy. Was embracing crosses really a healthy goal? How could you distinguish a sacred cross from a penchant for masochism or simple misfortune? What if you picked the wrong cross?

Take up your cross and follow Me.

What if I tried to value my pain and see it as an opportunity for
imitatio Christi
? Could Pain—this pain that, for no reason, had come upon me—be my cross? Should I try picking it up?

Why?
I felt diminished—degraded, even, by pain—not only physically but spiritually as well. I thought of a favorite Kafka short story, “In the Penal Colony,” that parodies the religious belief that physical pain can inscribe our bodies in sacred script.

In the story, a traveler visits a penal colony where an old Officer demonstrates his prized instrument of torture: a machine, called a Harrow, that literally uses needles to carve on the body of a prisoner a description of his crime, with pressure that increases over the course of twelve hours. The Officer explains that the nature of the prisoner’s crime is not told to him, but that six hours on the Harrow takes him to the point of enlightenment where he “deciphers it with his wounds” and there is a “transfigured expression from the tortured face”—a “glow of that justice, attained at long last and already fading!”

But the machine is rarely used anymore, the Officer laments: faith in its powers has been replaced by faith in modern jurisprudence. The spectacle of torture no longer draws happy crowds. Instead, the Officer performs his duty alone, executing the occasional prisoner. The torturer’s belief in the beneficent effect of torture on his victims proves wholly, shockingly sincere. The story at first appears to be a simple critique of torture, yet it turns out to be a critique of the broader idea of pain as passion, when, sparing the prisoner, the Officer unexpectedly throws himself on the machine.

“When pain transgresses the limits, it becomes medicine,” commends the nineteenth-century Sufi mystic Ghalib. Yet the Officer’s sacrifice only destroys the machine; its gears break, its needles pierce rather than inscribe his flesh, and their message is lost in blood. The Traveler “could discover no sign of the promised transfiguration” in the mutilated corpse, no moment in which the Officer had tasted, as Saint Teresa of Avila puts it, “the sweetness of this greatest pain.” Yet the blank stupidity of the Officer’s conviction appears unshaken: “His lips were pressed firmly together, his eyes were open and looked as they had when he was alive, his gaze was calm and convinced. The tip of a large iron needle had gone through his forehead.”

Pain inscribes the body in Kafka’s world, but the words turn out to be gibberish.

Take up your cross . . .

I didn’t want to be in Pain; I didn’t want to want it. Pain is not a cross; it’s a Harrow. There is nothing to decipher; the language of pain dissolves in suffering.

I scrapped the idea.

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