Pain and Its Transformations: The Interface of Biology and Culture (Mind/Brain/Behavior Initiative)
Harvard University Press, 2008
456 pp., $59.50
When I called a physician friend for advice on an adverse reaction to anesthesia after minor surgery, he made the offhand comment, "You know, veterinarians don't have that problem. They measure out the dosage, give the injection, and the horse or dog or whatever responds according to the book." That simple observation could serve as a summary of what prompted Harvard conveners to bring together molecular biologists, neuroscientists, pain clinicians, psychiatrists, anthropologists, musicologists, and scholars of religion for the conference that spawned this book. Physiologically, pain in humans may resemble that of horses and dogs, but there the similarity ends. In many ways, culture trumps biology.
Consider the phenomenon of Couvade, documented in many places worldwide. In some societies in Micronesia and the Amazon Valley, for example, the mother shows no indication of suffering during delivery. She may break from work a mere two or three hours to give birth, then return to the fields. By all appearances the husband bears the pain: during the delivery and for days afterward he lies in bed, thrashing about and groaning. Indeed, if his travail seems unconvincing, other villagers will question his paternity. A journalist or anthropologist who tried to explain, "Sir, there's no reason for you to feel pain because, after all, it was your wife who bore the child," would doubtless meet a hostile reaction. For months the father has struggled with such symptoms as nausea, weight gain, constipation, headache, and other signs of distress, not to mention the agony of the "delivery" itself. For him, the pain is as real as it is for the Manhattan socialite demanding her epidural.
Before attributing this cultural phenomenon to a primitive, unscientific world view, remember that placebos, nothing more than sugar pills and saline solutions, work well in developed countries. Around 35 percent of cancer patients report substantial relief after a placebo treatment, about half the number ...