Why Don’t We Take Mental Pain as Seriously as We Take Physical Pain?
A psychiatrist explores cultural bias and the history of medicine
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One of the first patients I saw in medical school was an elderly man dying of metastatic colon cancer, which had spread to his bones and was excruciatingly painful. I was shocked and heartbroken when I saw him beg the doctor for more pain medicine than the modest doses he was receiving. When I asked the attending physician if we could increase the dosage, I was told “no, he’d become an addict.” This was incorrect, illogical, and inhumane — as it turned out, the man died in agony. He would have never become an addict and even if he did, he had only weeks to live. If this had happened a few decades later, this same patient would be in hospice care receiving as much pain medicine as necessary. He would live out his remaining weeks with minimal pain.
Questions about treating severe pain began with the use of chloroform in the 1800s. Surgeons wondered if it would interfere with healing or if moral consequences, such as addiction, might emerge. These two themes: interfering with a natural order (in this case, wound healing) and having moral implications, arise again and again in attempts to treat pain.
Nowhere are these issues more prominent than with childbirth anesthesia. The use of chloroform changed the excruciatingly painful process of childbirth for the first time in human history. In spite of this, it took many years to become an accepted practice. Objections ran the gamut from concern about interference with a natural process in dangerous ways, to blocking God’s retribution for Eve’s sin in the garden of Eden (a common belief, explicitly stated in the Bible, about the origin of childbirth pain).
After much contentious debate, childbirth anesthesia was eventually accepted and women now at least have the option of managing the most painful parts of childbirth (there are groups of women and physicians who advocate for “natural childbirth,” that is, without pain…
