A doctor’s personal and unsparing account of how modern medicine’s failure to understand pain has made care less effective
In The Song of Our Scars, physician Haider Warraich offers a bold reexamination of the nature of pain, not as a simple physical sensation, but as a cultural experience.
Warraich, himself a sufferer of chronic pain, considers the ways our notions of pain have been shaped not just by science but by politics and power, by whose suffering mattered and whose didn’t. He weaves a provocative history from the Renaissance, when pain transformed into a medical issue, through the racial legacy of pain tolerance, to the opiate epidemics of both the nineteenth and twenty-first centuries, to the cutting edge of present-day pain science. The conclusion is clear: only by reckoning with both pain’s complicated history and its biology can today’s doctors adequately treat their patients’ suffering.
Trenchant and deeply felt, The Song of Our Scars is an indictment of a broken system and a plea for a more holistic understanding of the human body.
Warraich (State of the Heart), a physician who suffers from chronic pain, explores the biology, psychology, culture, history, and treatment of pain in this fascinating meditation. Warraich distills pain into three components: nociception, "the sensory nervous system's response to stimuli"; pain, the meaning given to the sensation; and suffering, the way one interprets that meaning. He posits that in medical contexts, these aspects are often conflated, and points out the how pill-based treatment that has resulted in "eerily similar cycles of opioid outbreaks" throughout history stems from an over-focus on the initial nociceptive response. Warraich draws on thinkers such as Descartes (who believed "only humans were capable" of feeling pain), Freud (who believed pain was closely tied to emotions), and Tolstoy (whose stories offer an example of "medicine's new antiseptic approach to the management of pain"), and covers such emerging interventions as ketamine, cannabis, and acceptance and commitment therapy. Warraich makes a convincing case for a deeper understanding of pain and a "truly person-oriented' " healthcare system: "Synthesizing our knowledge about the fundamentals of pain could move us closer to a future in which even if we hurt, we don't suffer." This solid survey makes a memorable case that those in pain need not suffer in silence.