To the Editor:—Caton relates our ambivalence toward pain with lingering archaic concepts of its causes. [1] He elegantly describes an evolution of the social significance of pain in Western civilization—from punishment by powerful gods and suffering synonymous with being human during the Biblical and Middle Ages to a pathologic experience requiring control and prevention. He concludes that current expectations for relief compete with an atavistic belief that pain and suffering may be an integral part of life. His interpretations are based on an exegesis of classical authors and clerics and seem logical. However, our contemporary heroes and pop culture also describe simultaneous feelings of pain abhorrence and glorification and perhaps portray them more vividly.

To illustrate the entightened 20th-century view abhorring pain and burdening society to eliminate it. Caton should include Albert Schweitzer, a physician and Nobel laureate, who practiced the ministry of relief in which he believed. Schweitzer wrote: “We must all die. But that I can save him from days of torture, that is what I feel as my great and ever new privilege. Pain is a more terrible lord of mankind than even death itself.”[2] Mother Theresa continues this selfless service. Our hopes for relief from pain and affliction soar when thinking of such superhumans.

It is unfortunate that reality often differs from hopes. Twentieth-century humankind is apostate and philistine and glorifies athletes and entertainers. These are the social leaders who often form our feelings and justify our actions. What are they saying about pain? Athletes extol it. Those who can't “tough it out” are wimps. Pop musicians sing, “It hurts so good/come on, baby, make it hurt so good/sometimes love don't feel like it should” John Mellencamp)* and “I hurt myself today/to see if I still feel/I focus on the pain/the only thing that's real”(Nine Inch Nails).** The recent hit movie “Natural Born Killers' glamorizes gratuitous violence and indifference to pain. Bruce Springsteen explains the popular reason for these actions. “I guess there's just a meanness in this world.”***.

To understand our ambivalence toward suffering and the persistence of traditional concepts valuing pain, as described by Caton, we need only to listen to the songs of today. If we want to abolish pain and suffering, we most also change our lyrics

Robert E. Johnstone, M.D., Professor and Vice Chairman, Timothy Fife, D.O., Resident., Department of Anesthesiology, West Virginia University, P.O. Box 9134, Morgantown, West Virginia 26506–9134.

(Accepted for publication December 13, 1994.)

*Mellencamp J, Green G: Hurts So Good (C), 1982 Windswept Pacific Entertainment Co. d/b/a Full Keel Music Co. International copyright secured. Made in USA. All Rights Reserved. Used by permission.

**Reznor T: Hurt. New York. TVT Music. 1994. Reproduced with permission.

***Springsteen B: Nebraska 1982. Reproduced with permission.

Caton D: “The poem in the pain”: The social significance of pain in Western civilization. ANESTHESIOLOGY 81:1044-1052, 1994.
Schweitzer A: On the Edge of the Primeval Forest. New York, Macmilan, 1931, p 62.