An unflinching look at pain

Part memoir, part journalism, an examination of the history, causes, and treatment of the chronic suffering that plagues millions

August 22, 2010|Alec Solomita, Globe Correspondent

You don’t have to be a masochist to derive a great deal of pleasure from Melanie Thernstrom’s “The Pain Chronicles.’’ An ingenious mix of science, history, investigative journalism, and memoir, Thernstrom’s book attempts (mostly successfully) to pin down that mercurial moving target — physical pain, particularly chronic pain. If you’ve ever sat in a doctor’s office and tried to explain how, where, and when something hurts, you have some notion of the energy, precision, and diligence necessary to produce this masterful overview of the subject.

The book is artfully sectioned into five distinct yet supple parts: Pain as metaphor, history, disease, narrative, and perception. The flexible structure effectively carries the reader into and through the various countries of Pain, as Thernstrom puts it. And within each part, Thernstrom glides gracefully from discipline to discipline. But what fuels “The Pain Chronicles” is the narrator’s personal story. As a result of an ill-fated swim, Thernstrom has endured chronic pain for more than a dozen years, an unrelenting pain that “filled the house of my body like smoke.”

Thernstrom doesn’t suffer alone. She cites a 2009 report that estimates that “chronic pain afflicts more than 70 million Americans.” And chronic pain, unlike acute but temporary pain, is often as mysterious as it is widespread, resulting from a confusing variety of ailments (or sometimes, seemingly, no ailment at all). Thernstrom meticulously delineates the many causes of chronic pain, its legacy of misapprehension, and the latest advances in fathoming the condition. “[I]t is only in recent years that chronic pain has been understood to be a condition with a distinct neuropathology — untreated pain can eventually rewrite the central nervous system, causing pathological changes to the brain and spinal cord that in turn cause greater pain.” To better understand the phenomenon and its latest treatments, Thernstrom spends years talking to scores of researchers, practitioners, and patients at seven major pain centers. She makes sense out of strategies ranging from hypnosis to Tylenol to opioids like OxyContin to Botox injections to the latest experiments in functional magnetic resonance imaging.