Pain

No Pain

She was making red lines and circles on the white sheet with the tip of her finger which was bleeding freely. The mother cried out and asked Tanya what had happened. The little girl grinned and showed her teeth, and there was blood on her lip. She had bitten off the tip of her finger and was now delighted with the red stuff that came out.

Tanya had been born with a genetic defect. She was perfect in every way except that she could not feel pain. The child could not understand what pain was all about. A monster, her father had called her. Not a monster, only a Victim of Painlessness.

Lepers

All down the ages people have reacted against victims of leprosy. They have been called "lepers" and turned out of society. The disease has been said to cause rotting away of tissues and fingers falling off. Now that we understand the disease a little better we know that most of these problems are not due to the germs of leprosy. The germs simply destroy the nerves of pain. Once pain is gone, patients destroy themselves.

Pain Frees

It is pain that allows me to be free. When I started to study medicine I would probably have said that my purpose was to relieve pain and suffering and to save lives. Today after a lifetime of treating those in pain and those without pain I would say that my purpose is to relieve suffering and to improve the quality of life. The main difference is that then I thought of pain as an enemy, while today I think of it as a help, indeed as an important element in the prevention of suffering.

How often I have heard people complain about God when they have pain. They do not blame God for giving us a signal that tells of disease or injury, but why make it so unpleasant and why not make it easy to switch off? Now I know why. Today there are ways to switch off pain. Pain killing drugs quickly become addictive because the addict seems to be living in a problem free and pain free world. We are seeing more and more of the results of this in our hospitals.

Easing Pain

Even when we know that pain is good and beautifully designed, we still have to face the problem that it some times goes on hurting even when we are doing all we can to get better. When we are busy even severe pain may pass unnoticed. There seems to be a gate - a sort of bottleneck -which limits the number of impulses of all kinds that can get across from the body to the brain. I remember in World War II how soldiers who had been severely injured would tell of how they lifted their helpless buddies and run to safety on legs. They said they scarcely felt the pain. Later, in the silence of the hospital ward those same soldiers would cry out from the pain of the hourly injections. When we understood the role of activity, we can often make pain very much more tolerable simply by keeping busy and active, and especially by giving all our sensory nerves a lot of sensations to carry.

Mind-Pain

Whereas pain, when it comes from in the body, is usually quite precise and quantitative in relation to its cause, when it gets up to the conscious mind its significance varies enormously according to how it is interpreted. Fear multiplies pain. A sense of helplessness multiplies pain.

Confidence diminishes pain. The realization by the patient he can do something also helps to minimize the pain.

How to Master

In ancient civilizations and cultures of India and to Southeast Asia where pain and hunger, disease and death, have been for centuries a part of every day life and where easy relief of pain by medication has not been available the people have developed a realistic attitude towards pain. The personal mastery of pain has become an important part of yoga and other forms of discipline. In the West we have come to think of pain as an unwarranted intrusion into our lives. Above all we have come to think of it as something that should be immediately suppressed. The whole thrust of television advertising repeatedly asks only one question about pain. How quickly can it be relieved. Product A relieves it 20 seconds faster than Product B. There is no hint that before the pain is relieved it should be understood and its message should be listened to.

Pain as Friend

Athletes are perhaps the only segment of our society who study pain and who deliberately impose stresses upon themselves. They rejoice in the fine interplay between stress and pain and exhilaration. If they achieve mastery over their own body, pain is no longer an enemy, but a valued friend. I believe that all of us, early in life, should deliberately cultivate the same attitude toward pain. It is not an enemy from outside, it is part of ourselves communicating with ourselves, it is expressing a need, it is explaining a condition, it is identifying a need for help.

The religious exercise of fasting has an important element of the same type of discipline. Not only does it provide a good climate for prayer and for the awareness of spiritual reality, but it also serves as a physical discipline. Every such mastery makes us better able to handle the unplanned physical stresses and pain that may come with illness or by accident.

Role Of Church

I think that the role of the Church and of the "laying on of hands" has been misunderstood in the modern church and that this lack of understanding has severely reduced the very real value to the patient which can come from the faith and sense of community shared within the church, the body of Christ. I see different and distinct roles that religion and faith can play in respect to the sick person. One is the so-called "Miracle Cure" in which the whole natural course of the disease or of the healing process may be dramatically and totally changed by supernatural intervention. The other is the awakening and activation of the normal channels by which the body is controlled and by the spirit and in which health flows from the proper focus and interaction of all the spiritual and physical forces that go to make up the whole person and the members of the corporate body of Christ with many members working together.

In a lifetime of treating serious disease amongst people who have faith as well as those who do not I have very rarely come across instances of the first type of spiritual healing, however, it has been my frequent delight to observe the second. I do not question the fact that God may choose to change or override the ordinary rules of nature, but I think that those times are so exceptional that we ordinarily do better not to seek them. I have known of very many instances of people who have been encouraged to claim a miraculous intervention in the course of their disease and who then feel let down when it doesn't happen. Then they feel that their disease is some kind of punishment or that God is against them and their loneliness is increased and their sense of isolation made more profound.

The Miracle

I believe that the real miracle is the wonder of human life and health as God created it and planned for every human individual. When we are taught that men and women are created in the image of God it means that our spiritual life and faith is central to our whole being and fundamental to its healthful operation. We are taught that the Christian church is to be like the body of Christ and each individual a member of the whole. When I observe disease in a person who has no faith and whose life is full of conflict within itself and within its family and community, I have a sense sometimes that the person is waging an ineffective fight against his disease. It is as though he did not have full control of all his own living cells. I can recall many other cases in which individuals have suffered from a severe, perhaps even a fatal disease, but who have faced it with serenity and confidence. They have felt the strength of their church and family community, who have come in to "lay on their hands."

Sharing

Almost every type of suffering is made easier to bear by being shared with others. Pain is no exception. There are many people, I am sure, who stay away from their suffering friends because they are afraid of their inadequacy and many such are the very ones who would be most helpful. There Is Room And Need in The Church For Much More Emphasis on The Visitation of The Sick. Those who have experience and insight in this field should be encouraged to conduct classes and to give guidance to those for whom it can become a real vocation.

Love

Whose Presence can relieve pain? The first, undoubtedly, includes anybody who already loves the patient. Love has a way of breaking through barriers and of knowing instinctively what the suffering person needs. Also a loved one will have a number of common interests, so it is not difficult to talk about things which will draw the patient's attention away from the hurt.

Being Natural

It is important that the visitors should be natural. The seriously ill patient is clinging to the familiar realities of life and the reality of his friends and relations is part of this. If you are ordinarily the kind of person who tells jokes, well then tell some jokes, if it is natural to you to read the Bible together, then read the Bible. If you ordinarily love to gossip, then gossip a little, be relaxed and hold hands.

Peace and Joy

Cultivate the quality of peace, and of quiet joy. I believe that the vocation of visiting the sick is a special gift of the Holy Spirit and it is one that can be cultivated. Perhaps the foundation of the gift is the personal faith and assurance that you carry with you. Those who have suffered pain and come through and those who know the experience of the grace of God in their own lives are sometimes the best ones to radiate that sense of peace and assurance to the person who is suffering. Sometimes the best arrangement is for the person actually in pain to minister to somebody else who is in pain. There is a spiritual magic about the sense of being needed and wanted which quickens the whole spirit because each is needed by the other.

Editor's Response

Dr. Brand, towards the end of the book "Fearfully and Wonderfully Made", makes these remarks which most fittingly can conclude this article: "Along with most doctors I know, I often feel inadequate in the face of real suffering. ..When suffering strikes, those of us standing close by are flattened by the shock....But when I ask patients and their families, 'Who helped in your suffering?' I hear a strange, imprecise answer. It is someone quiet, understanding, who listens more than talks, who does not judge or even offer much advice. "A sense of presence." "Someone there when I needed him." We want psychological formulas as precise as those techniques I study in my surgery manuals. But the human psyche is too complex for a manual. The best we can offer is to be there, to see and to touch."

Paul Brand is one of the world's foremost experts on pain. He spent 18 years of history-making research on it in his work with lepers in India. He is now the Director of the U.S. Leprosarium in Louisiana.

RESOURCE MATERIAL

• Dr. Paul Brand & Philip Yancey, Fearfully and Wonderfully Made Zondervan Publishing House, Grand Rapids, Mich.- An intriguing book on the masterpiece that the human body is and its further dignity as being part of the Body of Christ.
• Norman Cousins, Anatomy of an Illness Norton & Co., N.Y. - a personal experience and reflection on the capacity of the human mind and body to withstand illness. An excellent chapter on the work of Dr. Brand and his wife in their work with lepers and their research on pain.
• Leonard Bowman, The Importance of Being Sick, Consortium, Wilmington, N.C.- Engaging reflections on all aspects of illness with solid religious perspectives and practical applications for everyone: patients, professionals, et al.
• Jean Vanier, Be Not Afraid, Paulist Press, N.Y.- Intensely spiritual, poetical reflections on the mystery of suffering and the love of God.
• Philip Yancey, Where Is God When It Hurts, Zondervan Pub. House, Grand Rapids, Mich.- an excellent companion work to the above article. Explores the mystery of pain, using poignant examples, marvelous quotes and Sources. Moving material on Christ and pain.