Month: August 2018

The Agility of Suffering.

~ Roger JG Albert ~ 3 Comments

So, it’s almost September and time to get writing again. I haven’t been particularly active over the summer, but now I’m working up to a regular schedule of reading and writing.

It’s been an interesting summer, hot and dry with heavy smoke in the air at times. Wildfires still burn on the north end of Vancouver Island. And there’s been pain. Lots of it for Carolyn with her appendectomy and arthritis and me, well I suffer from chronic pain. I’m now seeing an amazing physiotherapist and it could be, it just could be, that I will find some relief from the pain that has plagued me for years around my shoulders, back and neck. I don’t believe there’s much that can be done about the pain that I still suffer from around the sites of past surgeries, one that removed a kidney and another on my lower back. I can deal with all the pain although it does make me cranky from time to time as Carolyn can attest, and it can drain me of energy.

I recently wrote about pain in this blog. I focussed specifically on the invisibility of pain and the fact that an individual’s pain is always assumed rather than demonstrated empirically. That is to say that if you break your leg in a biking accident, the medical professionals can easily ascertain the reality of the fracture, but the pain you would surely feel would not be evident, nor clearly measurable. When I got my left kidney removed in 2002 to excise kidney cell cancer, the general assumption was that I would have some pain. That assumption was correct and I was dosed with morphine to try to mitigate the pain. It worked, but years later I still feel the need now and again to take a T3, or Tylenol with codeine for the pain. The pain in my side from the surgery is still very real although the experts at the pain clinic at the Nanaimo General Hospital’s Pain Clinic were convinced when I was a patient there a few years ago that the pain comes from my brain and not from my side.

The pain your doctor acknowledges you must be feeling after surgery or a broken leg can only be measured subjectively, on a scale of 1 to 10, say. Some people, one in a million according to a couple of websites I consulted, cannot feel pain and their lives are extremely hazardous because of it.  Apparently, we need pain. It warns us of underlying problems and issues. It urges us to seek relief and balance.

Without any hard evidence, I hypothesize that people experience pain idiosyncratically. That is, some of us may be highly sensitive to pain while some of us are more or less inured to it. That goes for physical as well as psychic pain. In my next post, I want to address the issue of the amount of social, individual and economic resources that go into pain detection, management, and alleviation.

In this post I want to move away from pain somewhat to consider suffering. Suffering, although most people can agree on a general definition of it as generalized and sustained pain, has been vilified as a great social evil or hailed as the way to eternal life, in fact, the only way to eternal life. In a short blog post I cannot begin to summarize the importance that the concept of suffering has had (and still has) in human history. It is a concept that infuses so much of our existence and our attention. And it’s used in so many ways, hence its agility.

According to Friedrich Nietzsche, “To live is to suffer, to survive is to find some meaning in the suffering.” It’s worth dwelling on this quote for a bit. What does it mean “to live is to suffer”?

Well, I surmise that it may have to do with how we define suffering as essentially being unable or unwilling to change something. If I say, “I don’t suffer fools gladly”, that means that I won’t put up with their crap. Most people suffer fools silently as is sufficiently demonstrated in the U.S. at the moment. I suffer pain, but some people suffer loneliness (or the inability to form meaningful relationships with other people). Some suffer success (or the inability to accept the fact that they stand out). Some suffer fame (of the inability to accept the attention paid to them by larger numbers of people). To ‘put up with’ pain means to suffer pain. To suffer means to be blocked, to be unable to move to change or alleviate distress or pain, to lose control. To suffer means to be unable to accept life and death.

Shakespeare has Hamlet say in a famous soliloquy: “Is it nobler in the mind to suffer the slings and arrows of outrageous fortune or to take arms against a sea of troubles and by opposing, end them?” Hamlet must answer this question for himself. Should he silently put up with disloyalty and nastiness in the family or stand up and fight? Neither option is great, but Shakespeare’s meaning is clear.

So, how does this relate to Nietzsche’s aphorism? The way I read it, Nietzsche is saying that life is a process of helplessly awaiting death. Shakespeare gives Hamlet a choice between two paths. Life doesn’t do that for us. There is only one possible outcome when we are born. We suffer in waiting for our final breath. We can do nothing about it. We are helpless in the face of it. That is a basic definition of suffering. Of course, us humans with our big brains were not going to accept that fate, so we invented a myriad of cultural ways of denying death, of convincing ourselves that for us, death doesn’t exist.[1] Baptism is one ritual specifically designed to thwart death. Baptism, for believers, welcomes the initiate into a possible eternal life.

One of the more deleterious consequences of this obsession with denying death is the conclusion that any one group’s death denying immortality projects must be exclusive. Simply put, if my immortality project promises me eternal life, then yours must be a lie and must be defeated to prove it. A vivid example of this is congruent with colonialism. Christian missionaries who accompanied European traders, explorers and exploiters in the early history of the global spread of capitalist production considered it their duty to extinguish indigenous belief systems, forcing locals to adopt Christianity or face extermination. To a large extent, they succeeded although vestiges of indigenous immortality projects have survived to this day and are sometimes rallying points for indigenous cultural, social and economic revival.

For religious folk, suffering is a big deal. Christians and Jews are intimately familiar with suffering having been condemned to it in this mortal coil because of the follies in the Garden of Eden. In contrast, suffering is endemic to life as Thomas Hobbes maintained just because it is, history proves it. Jordan Peterson, a contemporary pop philosopher not remotely in Hobbes’ league, also finds that suffering is the essence of life as is brutality. He is not ‘religious’ himself, but he does support the religious view that suffering is essential. For Peterson, it is an indispensable element of human psychological growth.

It would be ridiculous to suggest that suffering is not an essential part of human and other sentient life. However, unless we agree to dwell on one end of the continuum of human suffering and human bliss, or accept the idea that life is itself suffering, we must accept that suffering is always contingent, conditional and situational. Life is not endless suffering for everyone. We are capable of moments of glee, pain free activity, both physical and psychic (or mental). Yes, we live and we die, but acceptance of that fact can alleviate much suffering.

Many religious folks, not just Christians by any stretch of the imagination, are focussed on arriving at that acceptance by denying earthly death. They defy their helplessness before death by handing over control over their lives to whatever god or deity they chose to create for themselves. Not all of us share in that type of denial. Those of us who are irreligious have to accept the fact of biological death like we accept the fact of biological life because, in fact, they depend on each other. Life cannot exist without death.

So, suffer away folks. As I write earlier in this blog post, I suffer from chronic pain. I’d like it to go away, but it’s not likely to happen. That means I have a choice to make, just like the choice Shakespeare gave to Hamlet. I can either suffer the slings and arrows of outrageous fortune or fight on until there is no more fight left in this old body of mine. I’m not particularly good at suffering slings and arrows, so I guess I only have one option left. That really simplifies life.

 

 

 

 

 

[1] For a thorough analysis of death denial there is no better source in my mind than Ernest Becker’s The Denial of Death, available on Amazon or better still, order it from your local bookstore.

The Conundrum of Pain…and Suffering: Part 1.

~ Roger JG Albert ~ 8 Comments

I’ve been thinking about writing this piece for a long time. It’s only now that I figured out how I wanted to organize my narrative. It’s complicated because there are so many aspects and approaches to both pain and suffering. The medical profession (and the medical ‘industry’) has its clear claim on the alleviation of pain and suffering. Philosophers and psychologists have also long been interested in the topic. Sociologists too. I won’t be quoting any sources this time. I will leave that for subsequent posts where I deal with specific scholarly and popular approaches to pain and suffering. To start, I want to suggest why I find pain and suffering of interesting.

Pain is not something that can be empirically determined. It cannot be objectively measured as far as I know. If you know otherwise, please let me know. That’s why doctors (MDs, that is) sometimes ask you: “On a scale of 1 to 10, how bad is your pain right now?” You answer: “Gee, I don’t know.” And you just throw out a number because it’s such a hard question to answer. You don’t want to say 2 because then what the hell are they doing in their office? You don’t want to say 10 unless you’re writhing in pain on the floor by the examination table. A 7 is usually good for attracting attention without getting ‘the look’. Still, your doctor may be wary.

You can look at anyone, I don’t care whether they have just been badly damaged in a car crash, they have arthritis, psoriasis, lumbago (don’t you just love that word?), and/or gout. You can impute that they’re in pain, but it’s not visible. Pain is not visible. You cannot see pain. It hides in the crevices, nooks and crannies of your body but nobody can see it so how do we know it’s really there? We may see a person with a massive slashing knife wound to the chest and we assume that person is in pain, but we never see the pain so we don’t have any way of determining its intensity or how much shock or other factors have mitigated or attenuated it.

Recently we (Carolyn and I) spent some time in a hospital emergency department because Carolyn needed an emergency appendectomy. All is much better now, but it was obvious that the medical staff were at a loss the first time we went to emerg (that’s what they call it, you know) to figure out what the cause of Carolyn’s pain might be. They may have even wondered whether or not her pain was psychosomatic. They poked and prodded her, took blood and did a CT scan. Nothing of significance was found. I don’t know what the staff thought at the time. They told her she was a conundrum and looked great on paper. In any case, we were sent home with instructions to take antibiotics, pain killers, etc. When over the next few days the pain got worse for Carolyn we went back to emerg after Carolyn was told by her family doctor that she had a classic case of appendicitis. After a few more hours sitting in waiting rooms and getting more tests including a second CT scan, it was determined that indeed, Carolyn had acute appendicitis (which we subsequently found out was evident on the first CT scan). Time for surgery for a ruptured appendix. This entire scenario was upsetting and did not need to happen. Surgery after our first visit would have been routine and we probably would have come home the same night. As it stood, Carolyn spent two days in the hospital recovering. Now, this was all nasty and everything, but I have questions about the presence of pain as Carolyn described it and the CT scan that showed an inflamed appendix. Did they operate because of the pain or because of the CT scan? The CT scan confirmed that there was an organic problem and the assumption that Carolyn was in pain may or may not have factored into the decision to operate. I’m not sure how that works.

Pain is not something that is determined objectively so how are medical personnel to know whether a person is in pain or is faking it? There are people out there who crave attention and will fake medical symptoms to get it. There are people who have what’s called indeterminate illnesses or diseases of indeterminate etiology like fibromyalgia. Some medical doctors and others associated with medicine still don’t believe that fibromyalgia is a thing. They argue that if only you’d relax, your pain would go away…that’s if you ever really had pain…wink, wink, nudge, nudge. It’s a tough call because pain is not visible. People may be grimacing and walking abnormally, and we assume they’re in pain, but we just don’t know for sure. There is probably more attention given to determining the etiology of pain in regular and emergency medicine than anything else. Guesswork has to play a major role along with targeted questioning. “Does it hurt here? No. Here? No. Then what about here? Okay, here then! Well then, we’ll just peel you off the ceiling now and figure out what to do for you. You will definitely need some painkilling meds. Get that IV hooked up. It’s certainly true that pain alone cannot trigger surgery. Just because I tell a doctor I’m in pain, that doesn’t justify her throwing me straight into the operating room. Subjective reports of pain must be supported by evidence of organic abnormality, or is it the other way around?

Killing pain is huge business. We don’t seem to like pain a lot unless we have a personality disorder and we’re masochistic. Big Pharma’s bread and butter is in killing pain. Opioids are huge business. They are used medically to mitigate physical pain symptoms, but they are also used on the street to deal with ‘psychic’ pain. [This is a topic for another blog post.]

Strangely enough, we often put ourselves through a lot of pain and suffering to accomplish a task that we’ve imposed on ourselves like running a marathon. Why run a marathon only to feel intense pain during and afterwards? What drives us to doing this kind of thing? [This is a topic for yet another blog post.]

Then, there are people, a very small minority, who cannot feel physical pain at all. They can put their hand on a hot stove element and not know that they are in trouble until they smell flesh burning. That’s not a scenario that appeals to me at all. In view of this it’s common to consider that pain has benefits in an evolutionary sense. It’s probably a damn good thing that we do feel pain. Too bad our pain is not obvious to others in an objective way. It would make life a lot less painful for a lot of us.