The Anthropology of Medicine: From Culture to Method

By Lola Romanucci-Ross; Daniel E. Moerman et al. | Go to book overview

she feels more pain. As J. H. van den Berg expressed it: "Pain may be caused by seclusion, by interpersonal dislocation" ( 1974:225-26). Moreover, not only isolation from other people, but detachment from things aggravates pain. The boat, in this example, connected this man with his father, with his past, and with a future. Perhaps this accounts in part for the observations ( Brena 1978; Nachemson 1994) that chronic pain is an epidemic in contemporary industrial countries. That the importance of beloved activities and their loss was expressed like the loss of a loved one in these narratives suggests that the phenomenon of chronic pain is in part a suffering of the loss of social connection, a loss that precedes the onset of pain and that provides the breeding ground for it.


CONCLUSION: THE SOCIAL CONSTRUCTION OF SUFFERING

What these analyses show is not a rigid pattern of experiencing pain and of recounting the story of being in pain, but the complex interplay between the events of life and the social and historical context in which they occur. Pain, at first glance merely a physical symptom, has a cultural history. What I have shown is the extent to which what I find to be most mine, namely, my story, is simultaneously, most ours.

The narrative structures of the chronic pain experience also suggest the difficulties faced by professional care givers who respond to the pain of such patients. If the narrative structures indicate anything, it is the extent to which current social arrangements throw people into an eternity of suffering. Our time is out of joint, not so much with the body as a biological organism, but with the body as a means of our being-in-the-world.


NOTES
1
The older explanatory model still occurs in these narratives, but its occurrence does not have the explanatory power it would have had two hundred years ago. Here are two examples: "Mornings are the worse. Mornings and evenings, rainy days or cold weather days. . . . The day before it rains, you can kind of like tell, it kind of pains in your back, it comes up, like, the spine." "When the weather changes, you're in a lot of pain. Because it's just horrifying, it's just like somebody's in there with an electric shock thing, going, 'Okay, the weather's changed, and now it's time for you to be in pain'. . . . And it was a bad time of year, it was really damp, and that made it even worse."
2
Some patients addressed me as an interested outsider and a psychologist (which is how I presented myself). Several of the patients confided in me about their use of "substances" with the explicit proviso that I not "spill the beans." At other times I was addressed as a representative of psychology or of medicine. In this capacity I was told what "you doctors ought to know." It is important but now always possible to know "who" is being addressed, but as with the context of the telling, the "I"

-270-

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