The Language of Pain
Pain is personal. Talk about cramps, migraines, or stubbing your toe to anyone else, and there is no way to describe the experience exactly the way you feel it, and vice versa. The words we have for pain are limited, and the ones that we do have fail to illustrate the gravity and incomprehensibility of paper cuts and cancer. I have had chronic pain for about four years. I have never had the words to truly explain what it means to be in constant pain. I don’t really remember what it was like to live without pain, and despite poetry and paintings, I still really struggle to get to the root of how to explain exactly what chronic pain feels like. But why? Language is the primary path to understanding, and yet in pain it is entirely lacking. I simply don’t have the words.
The Language of Pain by Dr. David Biro is a multi-disciplinary description of the ways we do and don’t have to talk about pain, mental or physical. Biro penned this as a young doctor facing a rare blood disease that required a bone marrow transplant. Struck and confused by the lack of words he had to describe what he felt, he set out on a project to consolidate and look at how we describe pain, and how we could consider talking about it in the future.
This book isn't new, but it encompasses a lot of theories and practices in literary and academic description of pain. As a species, we have been trying to accurately describe pain for centuries. Biro describes the rarely used Mcgill Pain Questionnaire for example. It uses a list of adjectives grouped by category, with each adjective having a corresponding score that at the end is used to determine how much pain a patient is in. It’s used rarely because it takes a long time, and aside from specialized pain clinics, using it is impractical. We are often forced to reach for metaphor and simile to describe simple adjectives cannot.
Many great writers take on the attempt to describe pain. Take Emily Dickinson, for example. In the book, Biro quotes a Dickinson poem, which describes pain as “[having] an element of Blank.” Biro argues that the problem with metaphor like this, however useful, is that “real people don’t talk like that, and if they did, physicians would most likely order a psychiatric evaluation.” Perhaps when we can make the language, it is perceived as too elaborate and thought out to come from anyone legitimately suffering. My personal favourite metaphor, of railway stakes being hammered into my joints, has itself garnered some strange glances.
What is by far the most common way that people describe pain is using what Elain Scarry describes as “the language of agency”. Biro quotes Scarry (check out her book The Body in Pain, it’s also excellent), who says that the language of agency is when “[people] imagine an agent that moves against and injures the body.” They then use this agent, whatever it is, to describe how they feel. This is where we get things like “stabbing” and “shooting” pain, despite no knife or gun being in sight. It is easiest to describe pain using words we know, in the same way that we often describe illness as a “battle” or “journey.” It’s militaristic and weaponesque qualities give us a basis of the known, like war and injury, in order to understand the unknown of pain.
What Biro ultimately suggests is that we can work with the language we have, if we can ground ourselves in trying to understand it’s very subjective nature. Even with its imperfections, language holds the key to pain more than a 1-10 scale ever could. To combine the beautiful metaphor of Dickinson with the laypersons adjectives have the potential to communicate the subjective nature of pain. What, in my experience, leads to the most understanding of pain is not only rooted in language and literature, but in sharing the discomfort. Biro ends the book, “language leads out to a thought that is no longer ours alone, to a thought that is presumptively universal.” During this pandemic, we have been reminded how much the power of language has to bring us together. We are all describing a pain that we haven’t seen or felt before, and with that, we have the potential to revolutionize our understanding of the individuality of pain. Pain is different for everyone, and yet right now we are all living a different reality of the same agony. I sincerely hope it gives us the language and the power to believe and convey our pain in the future.
By Lucy Farcnik