The Culture of Pain (review)

Book Reviews 325 David B. Morris, The Culture of Pain. Berkeley and Los Angeles: University of California Press, 1991. xii + 342 pp. Clothbound, $29.95. "Pain is never simply a matter of nerves and neurotransmitters but always requires a personal and cultural encounter with meaning" (p. 267). This basic assertion—that human pain is not a sensation, but a perception, something that exists only as we register and interpret it— is extensively and intensively developed and illustrated in The Culture of Pain, by David B. Morris. Morris's book will attract readers and provoke discussions in diverse realms. Specialists in the field of Uterature and medicine may constitute Morris's ideal audience, for his book, which compelUngly demonstrates the intellectual rewards of crossing boundaries , is an eloquent validation of their chosen field. The Culture of Pain will be of nearly equal interest to speciaUsts in literature or medicine. A successful achievement in the fashionable but amorphous literary arena called cultural criticism, it is at the same time a thoughtful exploration of a crisis with which contemporary medicine is grappling—the problem that chronic pain poses for individuals who endure it in a culture that reductively understands it as a mere symptom. But Morris also deserves a general readership. In appraising the experience of pain as something crucially shaped by minds and cultures, he takes on a topic of universal interest. As his study repeatedly shows, to be human is to feel pain and to make, or try to make, meaning out of that pain. The general lines of Morris's argument emerge in his introduction and his first chapter, "Living Pain: Mystery or Puzzle?" and are recapitulated in his concluding chapter, "The Future of Pain." Morris contends that the contemporary crisis of chronic pain is in large part due to our inadequate understanding, which is grounded in the postEnUghtenment scientific view that sharply distinguishes mental pain from physical pain and sees the latter as a sensation whose only meaning Ues in signaUng specific bodily malfunction. In fact, Morris says, physical and mental pain rarely exist in isolation from one another. Pain results from a biochemical process, but is also a subjective and cultural experience —something we feel as individuals, though our individual ways of feeling are in part conditioned by family, class, gender, ethnicity, time, and place. Acute pain is one thing, chronic pain another—or, more precisely, many others. The recent emergence of the pain clinic, where pain is considered the complaint rather than a symptom, challenges the old organic model's implication that, outside the bounds of medical knowledge, pain is a meaningless matter of nociceptive impulses. A different sort of challenge rises from the critical and historical study of 326 BOOK REVIEWS cultural change that The Culture of Pain offers. With Morris, we can come to see how our present denial of significance to pain rests on time-bound fabrication, not unchanging fact. We can see how the model of pain prevailing for the last century came to be constructed. We can revisit times and places in which other understandings of pain prevailed. We can listen to the voices of men and women who knew, in different ways, what eludes us today—that pain is not simply a puzzle, but at least in part a mystery, something necessarily veiled from full understanding. By presenting a rich variety of medical and nonmedical perspectives, The Culture of Pain helps us regain a sense of pain as mystery and urges us to assume personal responsibility for what it means to us. As Morris observes, "Medicine alone cannot possibly resolve all the questions raised by pain. The fault lies in asking doctors to assume the entire burden of a condition that stretches far beyond the borders of medical practice" (p. 290). It would be easy to imagine a slick, superficial, and eminently marketable treatment of so timely a topic as chronic pain, the invisible epidemic of our age. Fortunately, Morris has given us not that book but one far better: a scholarly, eclectic, original treatment that characteristically explores complexities rather than glossing over them. The book is a well-seasoned one because Morris has studied pain, its current paradigms, and its...