Melanie Thernstrom feels your pain as well as her own, as she explores treatments and the search for a "cure" in The Pain Chronicles (click here for review).
When did the idea for the book begin to take root?
It was a very slow process. My pain began 12 years ago, and I spent the first years wishing it away... trying alternative treatments, but it got worse. Then I got an assignment from the New York Times to write about chronic pain, and observed seven different pain clinics and hundreds of interviews between doctors and patients. I began to think, how many of these doctors' diagnoses are actually helpful and who will follow through? I was very interested in the communication between them. I became fascinated by the scientific research on the effects of pain on the brain.
Hospitals routinely mandate documentation of a patient's pain. Do you see a similar sensibility evolving among primary care doctors?
I think there's an enormous gap between what is known about pain in the lab, and what is known and practiced by the private physician. There's a big paradigm shift—it's now understood that chronic pain is not just a symptom, yet most primary care physicians don't know this.
You relate how one patient, Danielle Porter, who saw 82 doctors, finally found successful treatment with a chiropractor in Colorado. You note that your book doesn't have a lot of success stories. Are you one?
I have a metaphor about pain: our bodies are the landscape in which our lives take place. And not getting treatment for chronic pain is like saying you can't be happy because it's raining outside. I consider myself a success story. I wish I could be cured, but I think my pain is okay the way it is. Danielle Porter's inspired me! Maybe the people who get cured are the ones who leave no stones unturned.
You don't go into any detail about alternative therapies. Why?
I feel concerns that people misuse alternative treatments the way I did—as an excuse to think you're doing something about your pain and avoid Western medical treatment. Most of them are not any more effective than a placebo. It's fine if it's complementary [to Western medical treatment], but as a substitute, it can be quite dangerous. It's dangerous not to treat pain.
You recently read from your book at Yale's medical school. What was the response from those professionals?
They were very interested in the miscommunication between doctors and patients and wanted to know what they could do to make the patient "buy" the treatment.... Doctors have the responsibility to persuade the patient and to engage them on that primal level. And we talked about the idea that positive religious belief can help pain, even in severe illness, but negative religiosity—the feeling that my illness makes me feel God has abandoned me—is harmful. The spiritual dimension of pain was interesting to them.
