The Ineffability of Pain

For the sufferer, pain is the prototype of certainty – there’s no way to doubt that you have pain. But it is the exact opposite for those who observe a person in pain. David Biro

“Ineffable: too great or extreme to be expressed or described in words.” Many individuals are in pain much of the day. Their back hurts, they have an awful sciatic pain, a stabbing migraine that never goes away. They may try to describe their pain to another person. But there are no words for what the person is experiencing.

All they can do is groan, shout, screech or swear. And all the other person can do is listen and observe the behavior of the person in pain, a far cry from the person they used to be. They are bent over, in a slouch, rubbing their leg or forehead, trying their best to get from one place to another or reduce the pain in their leg.

“English,” wrote Virginia Woolf, “which can express the thoughts of Hamlet and the tragedy of Lear has no words for the shiver or the headache. . . . The merest schoolgirl when she falls in love has Shakespeare or Keats to speak her mind for her, but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.”

Consider a person who suffers from a spinal cord tumor, a tumor that puts pressure on nerve fibers and damages them. Or one who has had a compression fracture of the spinal cord, usually caused by osteoporosis or lifting something heavy, too heavy for their weak spinal cord.

Both can lead to severe back pain that is very difficult to treat. When a person with such a tumor or compression fracture tries to describe the pain they are feeling, once again all the observer can say is that they understand. But their pain cannot be felt.

Elaine Scarry writes about this difficulty in The Body in Pain: The Making and Unmaking of the World. “When one hears about another person’s physical pain, the events happening within the interior of that person’s body may seem to have the remote character of some deep subterranean fact.”

She says physical pain has no referential content. “It is not of or for anything. It is precisely because it takes no object that it, more than any other phenomenon, resists objectification in language.

Your doctor asks you to rate your pain on a scale from one to ten. You say it’s a ten, the most extreme point on the scale. But what does that number mean? Yes, it hurts a lot, but are there more specific words, instead of a numeral to describe your experience?

In an essay on medicine and literature, Andrew Solomon writes in the Guardian (4/22/16), “The language gap frustrates your visit to your doctor. He seems not to understand the problem because you can’t describe it lucidly enough. You don’t understand the proposed treatment because he can’t explain it. I’ve sometimes forsworn medical help because the complexity of voicing what is wrong has felt heavier than the sickness itself.”

In short, there are few words, if any for extreme pain, it resists the language available to a person and any attempt to describe it reverts to the “pre-language of cries and groans.”

Elsewhere, Ian Frazier wrote “Talking about hunger and being hungry are two different things; talk can wait for a convenient moment, but when you’re hungry you’re hungry right now.”

Frazier’s remark captures precisely the very general issue I am writing about, the discrepancy between words and feelings, between words and experiences.