On Conveying Pain/On Conferring Form

It feels to us immediate and urgent to present a special issue of Literature and Medicine on narrative, pain, and suffering. As one of the enduring commitments and justifications of our field, trying to understand the words with which sufferers register their experience consumes and probably unites the clinicians and the scholars in the field. To find or be reached by language that represents one's or another's illness is what establishes the intersubjective and ethical ground of healing, and is, in a way, the point of our discipline. Preceding narratives of suffering, there is isolation. With the narratives of suffering, there is comfort, or at least the possibility of it.

Paying attention to the narratives of suffering and pain changes all the terms of the equation. Narratives that emerge from suffering differ from those born elsewhere (unless one argues that all of the business of existing is, to some extent, suffering). Not restricted to the linear, the orderly, the emplotted, or the clean, these narratives that come from the ill contain unruly fragments, silences, bodily processes rendered in code. The language is deputized to point to things not ordinarily admitted into prose or poetry or text of other kinds—shameful, painful, prelingual limitations, absences, breath-taking fears. This use of language utters that which, once said, might change the world. Giving up, having had enough, and the unbearable heaviness of being are heard in our little clinic rooms, our green-curtained cubicles in hospitals, our darkened migrainous bedrooms.

We believe—and it is only our insistent optimism and crazed hope that allow us to do so—that understanding this language helps. Might there be, this special issue and—by extension—our discipline asks, something gained by our learning how to interpret this language? Might not the powers of medicine and nursing and therapy improve by virtue of our education in hearing others tell of pain? Might not we do better at our chosen tasks of cure or care or comfort to school ourselves in these parts of speech? And might not the powers of language themselves broaden by virtue of telling of pain?

It seems a soft bargain—you tell, I listen, you suffer, I listen. You confess your life is limited, your pain incessant, your suffering meaningless, and your body a betrayer of self, and I listen. So why are so few doctors or nurses or ambulance drivers or billing clerks or transport workers or clinic receptionists able to listen when ill people try to speak fully and bravely about what they go through? What is the barrier against absorbing these words of rage and grief and resignation? The listening, we have to allow, might not be without its own burdens of shame and fear. You tell, I listen so as to comprehend the limitations, the incessancy, the meaninglessness, and the betrayal of life lived in a body. Who agreed to that when they sent their application to nursing school or signed up for EMT training? Who, when healthy, has the receptive organs to register such talk? On the whole, such language floats above capture, in some airless stratosphere of words attached to nothing, because the hearer or the potential hearer lacks the machinery to take these words in, process them, extract from them their point, dwell in the presence of what their utterer means to say. And so this becomes our task—to equip ourselves, when healthy or, perhaps, when ill, to get what those in pain tell us.

We are able to point to these questions and pose them because of a confluence of interest and skill about us. Linguists, writers, patients, and those who care for the sick are more and more committed to the idea of putting these things into words. Theorists of language are attuned to the corporeal aspects of utterance. Activists and advocates have had it with the chronic silence and disregard that usually greet efforts to tell of suffering. Testimony and trauma studies give us vocabularies and even methods for eliciting and honoring stories of suffering. These stories, on the whole, are seen as valuable—to...