According to Frank Vertosick, pain is in your brain. "Pain isn't synonymous with life," he insists, "it's synonymous with intelligence." Human beings have few physical defenses, so we must learn to avoid danger. And pain -- which we hate -- both alerts us to danger and teaches us to dodge it. Really, we should appreciate pain, says Vertosick; by paying attention to its signals, we may learn to avoid suffering entirely.
Vertosick, a neurosurgeon who explains intricate systems simply, has won praise for his memoir of doctor training, When the Air Hits Your Brain. In his new book, Why We Hurt, Vertosick brings his empathy and skill to the broader subject of human pain. He considers an array of torturous conditions and then considers why being human hurts so much. And through his deliberate, insightful study, Vertosick reaches a conclusion: Pain is a necessary phase in our evolution. "Pain is not a punishment from God but a natural process," he argues. "This book is about the biological nature of pain and our attempts to expunge it from our lives.... By understanding the beast, we will be better equipped to grapple with it." Intelligence brings us pain, but it also brings us closer to pain's cure.
Vertosick's study begins with a consideration of our most common ache: migraines. These explosive headaches happen when arteries of the brain and scalp clench, then stretch unbearably. Migraines are so terrible, he explains, that sufferers can barely shift their heads without misery; any activity torments. Vertosick carefully sorts through these symptoms and then wonders if migraines might be acting as an evolutionary guide. Perhaps, he suggests, they teach us stillness: "Migraines are supposed to incapacitate us, at least temporarily.... Migraines are like a stern but benevolent parent telling us we've been through enough and should attempt to do no more for a while." In other words, headaches urge us to slow down.
For Vertosick, all pain figures into nature's plan. For example, the distress of labor prods women to give birth quickly. "Labor is a dangerous time.... Escalating pain forces the mother to pay attention and drive the event to completion as quickly as possible." Pain speeds labor and protects babies from the difficulties that arise during the birthing process. In this way, pain teaches us how to protect ourselves and our children from the most lethal of dangers.
Pain teaches us how to survive so well, in fact, that it can cause problems. For example, trigeminal neuralgia (TN), a disease in which worn facial nerves tear at the cheeks and nose, arises because we can outlive our nerves. "Maladies such as cancer, heart disease, arthritis, and TN are modern curses, targeting the burgeoning populations of elderly who have been shielded by technology from natural selection," Vertosick notes.
But if pain sometimes causes problems, it can also teach us to solve them. For example, Vertosick observes that our increased life spans have made us prone to slipped discs: "Since we've only been using our newly upright spines for a few hundred thousand years," he shrugs, "there has been no time for natural selection to work out all the kinks." But he also points out that pain can still teach us to ease suffering: "Evolution didn't abandon us entirely. Our erect posture damages our spines but also frees our hands, giving us one way to compensate for our rupturing discs: we can now become surgeons and remove them." Pain has taught us to live long, Vertosick suggests, and now it is teaching us to live comfortably. In our evolution, the painful burden of intelligence has become our best hope for relief.
After all, the history of pain is also the history of medical triumph. Headaches have driven humans to develop stress management treatments; phantom pain has spurred on specialized spine operations. The wretched face pain of the elderly has advanced our understanding of microvascular decompression, a treatment in which a nerve is cauterized to kill pain pathways. Wherever there is pain, doctors have found ways to soothe it. The pain of childbirth is treated with Lamaze breathing techniques; autoimmune disorders are treated with steroids. Carpal tunnel syndrome, that modern bugaboo, has driven surgeons to develop both vitamin therapy and sophisticated surgical releases. Heart disease, as Vertosick points out, brought us aspirin.
For Vertosick, pain teaches us about our origins and our future. When we consider the evolutionary reasons for pain, we can also consider our evolution as healers. "If we study all the triumphs of the human psyche over great diseases and injury," Vertosick promises, "we will see that the body is indeed the lesser partner in the mind-body dualism. We must try to shed the chains of pain, cloak our souls against the cold, and continue to climb our mountains." With Vertosick's insightful guidance, we do.