Wince-inducing stories of amputations without anaesthesia and sinister policies to withhold drugs from sections of society
Before reading this book, I had lived a life in utter ignorance of the MGS. That is, the Mouse Grimace Scale, a “standardised behavioural coding system with high accuracy and reliability” (according to the scientific literature) used by experimenters to determine how much pain a mouse is in. Professor Bourke’s book is about pain in humans, but the mice appear in a chapter that asks whether gestures of pain are innate or learned. Research into animal expressions to help us understand human ones has a pedigree, if I may use the word, that goes back at least to Charles Darwin.It seems that the answer is both. We learn that different cultures are taught to react differently to pain, and that facial and gestural reactions to painful stimuli are not universal. “A child has hurt himself and he cries; and then adults talk to him and teach him explanations and, later, sentences. They teach the child a new pain-language,” as Wittgenstein puts it in Philosophical Investigations, and quoted here.
However, pain’s essence lies beyond articulation. Our attempts to describe it, as Bourke notes, are almost always inadequate. And pain is boring: horrible and seemingly relentless, wholly preoccupying and unwelcome. What is interesting – and this is one of the book’s strengths and wherein lies much of its usefulness – is in the way those who have to deal professionally with pain do so. The section on surgeons who operated before the invention of anaesthetic is particularly wince-inducing. With no means of controlling their patients’ pain, surgeons had to be swift and deaf to cries of agony, leading to criticisms of inhumanity. However, it was best thus. “The great surgeon Sir Robert Liston could remove a limb in less than a minute, but even lesser surgeons were renowned for their speed and their firmness,” writes Bourke. Not all surgeons were so competent, or their patients so – relatively – fortunate. Here is the testimony of Emma Edmonds, a nurse at the time of the American civil war, commenting on one surgeon’s efforts: she “once saw a surgeon amputate a limb, and I could think of nothing else than of a Kennebec Yankee whom I once saw carve a Thanksgiving turkey; it was his first attempt at carving, and the way in which he disjointed those limbs I shall never forget.” Once again, it is comparison with the animal that brings home what it is to be human.
Continue reading...