PAIN - A DEFINITION (or two or three) . . . continued.
Pain - from the patient's point of view. There is no adequate language for the expression of pain in terms of type and intensity, or even frequency. The patient senses the location of the pain. They can describe the relative temporal relations of the pain: it is worse at night; it is worse during the day; it is worse during exercise. They can describe the pain categorically: burning pain; aching pain. They can describe the location of the pain. However, when the pain is at an extreme level or has over-saturated the patients sensory system, it becomes very difficult for the patient to express the nature of the pain. They may just groan or scream or cry out or just grit their teeth or perspire. The physician is hard-pressed to elicit an informative response from the patient.
People in pain become very focused, upon the pain. In a setting of friends or family, pain is all that they talk about, twenty-four hours a day. They drive everyone crazy, within hearing range. They are totally preoccupied with pain. Chronic pain sufferers complain of exhaustion, fatigue and tiredness almost as much as they complain about pain. Pain is an absolute certainty for these people. It is unrelenting and never stops. However, the people around the sufferer are skeptical that the pain exists, because they do not feel it and cannot see it. They only hear about it.
Pain and suffering, are different subjects. If you ask the average physician to define suffering, he would probably say, "well, I never thought about it." Physicians balk at the phrase, "pain and suffering," because it is usually part of a malpractice suit. They dislike even the juxtaposition of the two terms. It seems strange in the universal category of human experience that a physician would tend to shy away from the word suffering. Physicians don't really know all that much about suffering. There isn't a theology or a philosophy or a religion that hasn't attempted to deal with suffering to some degree.
The most important feature of suffering is that we suffer when we begin to have no hope for the future. Suffering frequently accompanies pain, but not always. You suffer when you are choking or when you're having difficulty breathing or experiencing prostrating diarrhea. You suffer when you see someone, about whom you care a great deal, dying or in pain. You suffer when your children are ill or suffering. Suffering and pain often occur when there is no hope that it's going to get any better or when you begin to think that the pain has a dire meaning. For example, if I have a pain in my abdomen and if it's there for four or five days and nobody can find anything wrong, I'd begin to wonder if I've developed a bad disease. Then I suffer with the pain. If we try to define suffering, as Webster does, "a state of extreme distress in a person," not in a body but in a person, we communicate very little about suffering.
