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Full 1997
The Prince of Pain
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"The
dictum ‘pain does not kill,' sometimes invoked to justify ignoring
pain complaints, may be dangerously wrong," Liebeskind wrote in
a widely circulated editorial titled "Pain Can Kill." "Our results
suggest it is not only safe to use analgesic drugs for controlling
cancer pain in man, it may be unsafe not to."
Liebeskind
became something of a crusader in an effort to upend traditional
medical thinking, which telegraphs to patients the message that
agony is virtuous. Implicit in the physician's offer, "We could
numb that pain for you, if you'd like," is the presumption that
there's something noble about suffering. Liebeskind questioned why
healers question a patient's instinct to artificially separate himself
from his pain. Perhaps pain isn't growth, Liebeskind asserted, though
common wisdom holds otherwise.
A social
thoroughbred, first-class talker, wizard at working the phones and
widely respected researcher who spent 30 years helping doctors understand
the baroque psycho- biological processes that occur when humans
are hurting, Liebeskind was an irresistible lobbyist for a scientific
establishment not renowned for leaping to embrace radical new ideas.
When
Liebeskind joined the UCLA faculty in the mid-'60s, the field of
pain research was as empty as a Bosnian minefield -- and about as
well mapped. Most doctors understood the body's response to, say,
a burn, essentially the same way Descartes did: Fire touches skin
and sends a flare through nerve fibers to the brain, which registers
the sensation and tells the body to jump. "Just as by pulling one
end of a rope," Descartes wrote in 1644, "one makes to strike at
the same instant a bell which hangs at the other end."
This
peripheral nerve [ck Carey's note] theory, as it's called, pictures
the body as a Rand McNally of one-way pain pathways converging on
a central-city consciousness, and served to explain everything from
paper cuts and stubbed toes to hammered thumbs. But it could not
account for more exotic phenomena, such as the fact that athletes
and soldiers could suffer awful wounds and feel nothing for hours.
Or even for the universal balm of rubbing a wound: Why should that
help if pain shoots directly into the brain?
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