"Quit being such a pain in the butt." "He broke my heart." "Ouch... that was a bit harsh, don't you think?"
All of these statements bring to mind some form of pain, though not usually the form we tend to associate with the word 'pain'. After reading an article the other day (I'll get to that in a bit), I began thinking about what exactly pain is. Obviously, when you do some sort of damage to yourself, and it hurts, it's called pain. Hospital patients are told to rate their pain on a scale from 1 to 10, 1 being no pain, and 10 being the worst pain you've ever felt (though, my dad says a 10 would mean that you aren't sane enough to say a ten, because it hurts so badly.
But what about other forms of pain? Emotional and mental pain? Referred pain? Sympathetic pains? How do we determine if those are real?
Furthermore, for people who can't tell us that they're in pain, or even animals who can't tell us, how can we tell? Is it the anguish on their faces? Their blood chemistry? What?
Well, let's start with the basics. Pain is a mechanism your body has to tell you you're hurt in some way. It is part of the innate immune system, right alone with your skin and your macrophages. So, when you fall and hit your knee, it's gonna hurt.
Why? Because there are some nice little nerve endings in your body that send signals to your brain telling you so. Which brings us to referred pain. Many of these nerve endings share endings with other parts of the body. For example, your heart shares the same nerve for pain as your left arm. Sometimes, your brain mistakes the end it's coming from, and interprets it the other way. So, when your heart is experiencing pain (say... during a heart attack), you don't feel it in your chest, but rather along your left arm.
According to the article I read, though, pain involves a lot more than that. Pain stimulates the release of a whole bunch of hormones, in an attempt to get you out of the situation that is causing you pain. Among other things, cortisol and adrenaline are released. When the response is extreme enough, it could kill you from shock. This is, of course, why we administer anesthesia to patients undergoing surgery.
Up until recently, infants were not getting anesthesia, and many were dying after major surgery. Why weren't they getting anesthesia? Because doctors didn't believe they experienced pain (this of course gets into a big long discussion that I care not to right now, so we're going to focus on things after birth). Many are still iffy on the subject. Why?
Well, how do you know you're in pain? You say it hurts, right? But two people experiencing the exact same stimulus... say a pinprick to the finger... one could feel only a minor discomfort, and the other could experience a fair amount of pain.
So we look to the hormones, right? But those specific hormones are stress hormones, so they can be produced by the body under physical or emotional stress. Lifting heavy boxes all day could potentially release these hormones, if you are not used to doing so. Does it hurt? Maybe, maybe not. Additionally, as the article points out, these hormones are elevated in brain dead patients as well during organ harvesting. Do we think they can feel pain as well?
Which brings me to another point. Emotional stress can lead to physical pain. Ever study for finals or exams so much that you literally get sick to your stomach? Ever had tension headaches? Ever been depressed? Each of these has an emotional event (or series of events) at its foundation, and yet causes physical pain. (Similarly, physical pain can lead to emotional stress.)
So, what is pain? It's obvious that it's some subjective value. Two people could not experience the same level of pain with a specific stimulus. Does this mean infants, who have the capability, but perhaps not the experience, to process pain, might not feel it? At which point does pain develop, and what is required, anatomically, to process it?
This question obviously has far reaching implications. To those who cried in outrage of Terry Shiavo, you can see the implications... starving a person to death isn't very humane if they can feel it. Of course, since euthanasia is currently banned in the US, where would that leave us? Do children with a damaged cortex still feel pain? The questions can go on and on...
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I completely agree with the part about emotional pain leading to physical pain. I recently was broken up with by my boyfriend of over 2 yrs. I was devastated. My heart ACTUALLY hurt, I didn't think that was possible. I just had this pain in my heart that I couldn't explain. But love is a funny thing, causes pains you never even knew you had.
One thing I actually didn't mention was literal broken heart syndrome. After some traumatic event, some people will experience heart attack like symptoms, but there will be no damage to the heart, at all. I've heard of it happening a lot on the anniversary of a family member's death, for instance. I might've blogged about that before... I've been doing this too long to remember.
~C
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I think that this notion also has further implications outside of the human race. Not to turn this into a vegitarian/ animal rights debate, but if animals feel pain (which, obviously, they do), is it still morally just to kill them? And do we even care about the pain of a non-human?
I knew I was going somewhere with the animal comment... I just couldn't remember it by the time I finished writing.
There are some slaughter practices that, in theory, do minimize and/or eliminate the pain of animals, though. Kosher slaughtering requires that the animal doesn't suffer during the process, so in the slaughtering of cattle, for instance, the neck is cut in such a way that the animal dies almost instantly.
Of course, with the way we raise cattle, I'm not sure the slaughtering practices make that much difference in the long run, and there are certainly even violations in Kosher slaughterhouses.
~C
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I think the general theory is that the pain of a thinking, reasoning animal is more "real" than the pain of an unthinking animal i.e. the emotional trauma that goes along with physical pain for humans can't be matched by animals, so their pain is less important.
It is popularly understood that humans and perhaps some species of primate are the only animals with egos and so the only animals that can truly experience pain or fear of death. Other animals merely experience an instinctual want to live, not a fear of death or pain.
Frankly, I don't care. If it isn't permissible for humans to kill cows then it isn't permissible for lions to kill gazelles. That lion has teeth, and muscles behind them, specifically evolved to most effectively remove the throat from a running herd animal. It's tastes and mind light up with another animal's life blood dripping from its chops. It has the same right to kill gazelles as the gazelle does to kill grass. If that lion can kill an animal with a similar understanding of the world as itself then I can damn well contribute to pay to have a cow killed and a rare, bloody hamburger placed on my plate.
People have sharp, canine teeth to help with eating meat. We have minds and bodies capable of hunting for meat and creating tools to make that hunt easier or non-existent. Most of us enjoy the taste of one kind of meat or another. It is perfectly natural for people to eat meat, and perfectly permissible. Just as it is perfectly permissible for that lion to kill that gazelle, and believe me, that gazelle is definitely not killed particularly humanely. It dies in horrible terror and pain.
“Existentialism means that no one else can take a bath for you” - Delmore Schwartz
"Patriotism is often an arbitrary veneration of real-estate above principles." - George Jean Nathan
I went to a pain seminar while in nursing school. We were asked "how do you measure pain?" The answer is: pain i what a person says it is. If someone rates a papercut as an 11 on a 1-10 scale, then their pain is an 11. Pain management is one of the reasons why being non-judgmental is important in the health care field.
Sometimes people can't say what their pain is. Other ways to determine pain from those who can't or won't talk is by measuring heart rate and respirations--both tend to increase when someone is in pain.
You can also look at a person, sometimes, and tell. Someone may say they aren't in pain, but you can see that they're "guarding"--hold their stomach, holding a sprained wrist, etc.
Sometimes pains in children are caused by emotional stress. These are called somatic pains. Younger people don't have the mental capacity to deal with it and so the pain they feel appears as a stomach or headache. If a child is showing up to the nurse's office with a tummyache everyday, it's probably time to see what's going on in his or her life.
This was an interesting blog. Thank you. :-)
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"...There is a crushing guilt that comes with being a Catholic. Whether things are good or bad or you're simply... eating tacos in the park, there is always the crushing guilt."
-30 Rock-
Is motivation for the rest of my life.