cover image Pain: The Science of Suffering

Pain: The Science of Suffering

Patrick D. Wall. Columbia University Press, $75.5 (192pp) ISBN 978-0-231-12006-7

Wall (The Challenge of Pain), a professor of physiology at St. Thomas's Hospital Medical School (London), presents an alternative to the traditional theory of pain. Earlier theorists attributed painful sensations to nerve endings that transmitted a message from the spinal column to the brain. Drawing on the latest neurological research, Wall hypothesizes instead that when nerve endings are stimulated by painful sensations, the message is transmitted, but then, the brain analyzes this data to determine the appropriate motor response. One's response to the stimulus is, in part, based on personal history and expectations. According to Wall, this interconnectedness explains why people experience pain differently, and it also accounts for why a strong belief in the efficacy of a placebo may actually reduce an individual's pain. Although he doesn't examine specific conditions--like cancer and migraines--in as much depth as Frank Vertosick does in Why We Hurt: The National History of Pain (Forecasts, May 29), Wall is a sympathetic and thorough writer: he describes the physiology of the nervous system; he explores, philosophically and scientifically, the history of pain and its treatment; and he suggests some improvements to popular medical approaches to pain management, explaining (in detail) the different ways in which pain can be eased. Postoperative patients, for example, deal with their pain better when they are able to regulate their analgesic medication (because control helps them overcome their feelings of physical helplessness). In this generally thoughtful text, Wall offers his belief in the benefit of narcotic medications for cancer patients in pain. B&w illus. (Aug.)