31. Anesthesia and Decency

While pre-anesthetic societies affirmed pain as an inescapable and admissible phenomenon, contemporary Euro-Western civilization is increasingly linked to the conquest of pain. Anesthesia, analgesics, and over-the-counter forms of pain relief are increasingly available and affordable. As Leriche (1940) recorded, "Far more than our ancestors, we try to avoid the slightest pain, however fleeting it is, because we know that we have the means of doing so. And, by this very fact, we make ourselves more readily susceptible to pain and we suffer more. Every time we fix our attention on anything, we become more conscious of it. So it is in the case of pain" (pp. 56-57).

In the treatment of acute pain in Western medicine, anesthesia was believed unnecessary for certain demographics; infants, soldiers, and Black people, for instance, didn't typically receive anesthetics before even procedures as major as amputation, due to beliefs about pain sensitivity or ability to prove the experience of pain (Bourke, 2014, p. 275). In fact, some modern medical textbooks continue to perpetuate the myth that Black and darker-skinned people have thick, less innervated skin. According to Halttunen (1995), Western medicine traditionally took the orthodox Christian view that pain was inevitable and shouldn't be interfered with, as the body needed to suffer to heal. In the late eighteenth century, the medical quest for effective anesthesia led to an increasing middle-class sensitivity to pain. Physicians and surgeons became more averse to inflicting pain on their patients. Pain was reconceived as unacceptable, and social beliefs and literary trends reflected this (p. 309-310).

The pornography of pain emerged as a counterpoint to the new middle-class humanitarian sensibility: "highly voyeuristic in nature, dependent not only on the implied spectatorship of the reader/viewer but also on the express spectatorship of internal witnesses to the sexual infliction of pain" (p. 317). She goes on to say that: "If pornography is best defined as the representation of sexual behavior with a deliberate violation of moral and social taboos, then the growing violence of pornog- raphy in the late eighteenth and nineteenth centuries is attributable to the new shock value of pain within a culture redefining it as forbidden and therefore obscene" (p. 318).

These assumptions underpin ideological perspectives about chronic pain, namely that it stems from damaged nerves, though in idiopathic syndromes like fibromyalgia, it often seems to be the result of differently sensitive nerves (Barker, 2005). Chronic pain is so ordinary as to recede, always on the horizon, attention-depleting without being attention-absorbing. As Dolphin-Krute (2015) puts it, chronic pain is about deep boredom, which

although [it] is always partially paying attention to something (else, something you are not capable of giving your full attention to) it does not produce a state of being distracted. In fact, deep boredom prevents distraction because it constantly acknowledges present pain and how boring it would be to fully be in this pain and what a distraction this pain would become" (para. 43).

Not to mention that, under these assumptions, the ability to accept continuous pain becomes conflated with a pornographic predilection for pain, rendering the stoic chronic pain patient sexually as well as medically deviant.

As I pursue treatment from 2006 through 2007, I'm in pain and angry and bored by it, "functional" but visibly suffering and frustrated. My visible pain is mistaken for the acute, curable symptom of some other disorder. My pain tolerance is mistaken for deviance. It must be visible for me to be believed, but at the same time, this apparency is as unwanted and taboo. Modernity's confrontation with the spectacle of pain is characterized by repulsion (Halttunen, 1995). In the face of ocularcentrism, we are still pressured to suppress the affective transmissions of pain.

I am prescribed Schedule III and IV painkillers before I have an accurate diagnosis, which is antithetical to the Western biomedical construction of pain as an alarm bell in a flawed machine, inviting the physician/mechanic to identify the underlying biological/mechanical problem. Born of bourgeois principles of taste and decency, the need to eradicate pain, even if it means masking the signal, triumphs over diagnosis (Halttunen, 1995; Morris, 1991; Bourke, 2014; Derkatch, 2016). ↩