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The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering Hardcover – Bargain Price, August 17, 2010
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I loved THE PAIN CHRONICLES for all the same reasons that I loved Andrew Solomon's THE NOONDAY DEMON, and I think it's fair to say that THE PAIN CHRONICLES does for pain what THE NOONDAY DEMON does for depression. In both books, the author faces a potentially crippling medical issue and fights hard to vanquish it. Both authors try different, fascinating approaches, and fight a strong fight. Both use their formidable skills as journalists to not only address their own predicament, but to cast light on an epidemic -- but until very recently, poorly-understood -- disease. Along the way, both learn much more than they originally knew about the disease that is afflicting them -- and there are many surprises in the mix. No wonder Solomon loved the book and blurbed it. Neither author finds a cure-all; both find much reason for hope.
Thernstrom not only tells her own, fascinating story, but also tells other pain patients' stories and recounts her conversations with eminent pain doctors. If you suffer from pain, this book is invaluable -- it gives you a birds' eye view of the state of the art in pain treatment, coupled with patients' specific experience and doctor's specific advice, right and wrong. If you don't suffer from pain, the book remains completely fascinating. Thernstrom investigates how other cultures treat pain and provides a fascinating (and at times horrifying) intellectual history of pain treatment.
In short, I couldn't more highly recommend this book.
This book failed badly in both regards. First, from my experience and that of fellow sufferers, what are major, complex issues are only touched upon very briefly--between a paragraph and a page--in widely scattered sections of the book (the first of these was on page 55, the next on 145). Second, the author is a horrible exemplar of the effects of chronic pain. Although she _states_ that it was debilitating, the book does not present it as anything more than an occasional inconvenience. And the picture the author paints of herself is not only unsympathetic, but plays into various of the negative stereotypes (she comes across as indulged, immature, lacking discipline, failing to follow-through, ...).
The book is a series of short chapters, almost all are one to four pages, with the chapters being largely independent units instead of building on each other. Thus there is little opportunity for insight. For example, a chapter describing someone with chronic pain from a lost limb would be dominated by describing the person and the injury and the circumstances of the interview. The lessons-learned are typically so terse and shallow as to be useless, for example, the author stating that she didn't understand how the person with such injuries could have such an upbeat attitude. It's as if she wrote the chapters immediately after completing that piece of the (raw) research, but before she explored it and tried to fit it into a larger structure.
A lot of the author's efforts don't make it into the book. In the chapter on doctor-patient interactions (pg 210), she states that she sat in "several hundred appointments ... over the years", but then goes on to talk briefly about only one of those sessions, with the next chapter shifting to a different topic.
Because of the author's experience with her own chronic pain, I expected her to be able to better draw out and understand what other sufferers were going through. Instead, she writes with the studied detachment of a reporter (her profession), even when describing her own situation. Her writing in the book never gave me any sense of her having chronic pain, although you can see some of the effects of chronic pain reflected in various problems in the structure of the book. This book lacks the intensity and visceral descriptions needed to convey what is like to have chronic pain.
If you are feeling isolated by chronic pain and are hoping that this book will provide psychological support--by showing that "it is not just you" but that many others are facing the same difficulties--you are unlikely to find that in this book. Similarly, if you are hoping for stories that might help with coping strategies, there are few in this book. Of the stories of individuals, there seemed to be more focus on the injury that caused the chronic pain than on the pain and how it affect that person's life.
1-star ("I hated it") because was a near total waste of time for me. From the title I was aware that some of the book would be irrelevant to my interests, but the marketing materials portrayed it as, on whole, highly relevant.
Summary of contents:
Section 1 ("... Pain as Metaphor", pp 3-83) The author demonstrates that she is well-read about pain. For example, she enumerates which gods in various ancient cultures were associated with pain. And there are chapters centered on quotes of famous people (literary, medical, historical,...) regarding pain. And ones giving brief summaries of how various religions view pain. It wasn't that these _topics_ weren't of potential interest to me, but rather that they weren't developed enough to be of more than fleeting interest. Interspersed are irrelevant chapters about the author, for example, a chapter on when she went camping with friends and her tent fell down in a rain storm. I couldn't help but think of her as the Diane Chambers character in the TV show Cheers (1982-87). This problem also dominates Section 2, but then becomes much reduced although still present.
Section 2 ("... Pain as History", pp 87-124): On torture, surgery,... More quotes and minor facts of minor relevance, such as when England started requiring that a prisoner be hung _until_dead_ before being drawn-and-quartered.
Section 3 ("... Pain as Disease", pp 127-191): A meandering presentation of a few basics about medication and differences in pain sensitivities across individuals and for an individual at various times. Worth reading if you are unfamiliar with this and the book is readily available.
Section 4 ("... Pain as Narrative", pp 195-277): Of most interest to those with chronic pain. Some small interesting facts. Very brief introductions to issues that warranted major discussions. _Headlines_ of some scientific studies. Problem is that if you are already dealing with chronic pain, these chapters may cover little that you don't already know, and if you don't have the experience, the important bits may not be salient enough to catch your attention.
Section 5 ("... Pain as Perception", pp 281-329): Musings that don't add up to much.
Two examples of what I expected to find in this book, but didn't:
1. "It's hard to think about draining the swamp when you are up to your *ss in alligators." : The author briefly notes the situation where people with serious pain don't aggressively pursue recommended treatments or don't look for alternatives if the current treatment isn't working, but she doesn't explore why. While doing such would not be a problem for a normal person, these activities can be excessive drains on the depleted physical and mental energy and the time of the person in pain. The medical establishment seems clueless that what is easy to prescribe may not be easy to do, leaving the patients to figure out that they need to transform these into something sustainable. For example, I converted my prescribed finger exercises into massaging a cat, which had the dual benefit of positive feedback plus insistent prompting to do these "exercises" on schedule.
2. The need to identify and quickly jettison relationships that turn toxic. There are _some_ friends and family who will choose to believe the various misconceptions about chronic pain regardless of what you explain to them. Believing that they know what is best for you, they will sabotage your treatment by manipulating you into doing things you have told them you aren't supposed to do (via cajoling, guilt, threats, lies, trickery,...). And they will sabotage your mental health by making you feel like a loser through comments about you being weak and not trying, and by belittling the severity of your injury and pain. When you are in crisis, friends are so valuable that it can be very hard to let go of any relationships. Because you are struggling to just maintain existing relationships, you doubt you have the resources to cultivate replacements in a timely manner. You want to believe that existing relationships are fix-able: first that the problem is with your explanation, then that they just need more time and repetitions to comprehend, then that the accumulated damage to the relationship is still repairable. Coping with chronic pain requires drastically pruning back your life in many aspects to avoid being beset by preordained failures.
Aside: This phenomenon is also found in other "invisible" medical problems such as Chronic Fatigue (eg Lyme's Disease) and RSI/CTS (Repetitive Strain Injury/Cumulative Trauma Syndrome). If you have chronic pain, you should check out the support groups in these related areas--in your area they may be a better choice or may be a valuable supplement (RSI had the strongest groups at the time and place of my injury).
The book briefly brushes by this, but in a way that won't register with most readers, for example "you lose your friends, you lose co-workers, you lose everything" (pg 235) comes across as a simple lament rather than statement of an extended series of devastating defeats. The author appears unaware of this phenomenon because she seems to be a counterexample: During her chronic pain, she establishes several romantic relationships, including getting married. At the beginning of this period, the author preemptively dumps her boyfriend on the expectation that he would soon dump her for being sick.