Long ago, I remember my first encounter with Harrison’s principles of internal medicine. I was in 2nd year, it was a wintry December evening and I was in the library. I opened this textbook for the first time and started reading symptomatology. I was so absorbed by the book in no time. The first chapter I read was ‘pain’. “What a beginning”! I remember thinking.
I was intrigued by pain thanks to Harrison.
A large part of pain is psychological as most of us know. Just the suggestion of pain and attention to the pain-causing stimulus adds to the agony. Come on, didn’t the dull stinging in your heel turn into a full- blown, tantrum- throwing, howling when you SAW the thorn in your heel? Yes you poor baby, I know you were in pain, but your pain increased when you paid attention to what caused it.
The concept of fear of pain was what caught my fancy the most. Sample this,MOST of the neuronal projections carrying the sensation of pain project to the areas in your brain that sub serve unpleasant emotions like suffering, crying, and the sheer dread/ fear of pain. To explain better the fear of pain- consider the Chinese water torture where the victim dreads the next drop of water falling on his forehead or worse still, the small of his back. Drops of water fall in undetermined although frequent intervals on the small of his back or his forehead. The part becomes stiff and frozen after some time. The victim is in constant fear of the next drop falling on that painful, stiff area and the drops do not fall in regular intervals. The next drop could be seconds later or minutes later or the steady dripping may resume hours later. YEAARRGH! Frustration, pain, lord! Enough to drive anyone to insanity.
Pain modulation- soldiers don’t feel pain even when they suffer major fractures, thanks to their adrenaline charged states. Remember Rudy Youngblood a.k.a.’ jaguar paw’ running miles and miles to escape being caught by his captors even after being stabbed through and through in his abdomen? On the other hand, normally, you’d grimace even before the needle pricks your precious bum. Thanks to pain modulation, it’s theoretically possible to induce pain without any external stimulus. Think voodoo! I mean just expecting pain does weird things with your brain and you appreciate the pain more.
Pain tolerance is fascinating. Some women howl and howl in labour from the very beginning, while some clench their teeth and fists and get it over with without a single cry escaping them.
What’s a mild stinging for someone is a chest crushing tractor for someone else.
Pain is also addictive, think of those getting multiple tattoos or even self- mutilating ‘cutters’. Beyond a point, nothing is painful enough for that high they get after self harm. Scary! Fact is, the body’s defense mechanism is to release endorphins after sometime of suffering pain which alleviate it a little. People strive for that endorphin rush. Endorphin is an opioid after all. Err... Like morphine and heroine.
No, I am not a masochist, thrilled and turned on by the idea of pain. I just happen to have a certain innocent fascination for it.