Taj Taher

Honors 222 C
20 May 2015
Seminar 8 Thought Piece
Probably the most interesting insight from this weeks readings was from Mosseys
investigation of racial and ethnic disparities in pain management when she writes Whether
dueto culturally motivated pressures to appear stoic, the tendency for racial/ethnic minority
individuals to underreport pain levels appears their main contribution to inadequate or
inequitable pain management. Efforts to encourage individuals to adopt more empowered
attitudes and behaviors when seeking pain care appear warranted, (Mossey 1863). Mossey
provides several insights regarding chronic pain that seem to run contrary to what has been
established thus far. First is the notion of underreporting pain, a curious thought given that until
now, chronic pain patients have only ever seemed to over-report pain. The typical chronic pain
patient has thus far been characterized as an individual whose mindset would predispose them
not only to developing chronic pain but also exhibiting attention seeking behavior. However,
from what Mossey writes, it seems clear that just because one does not make a fuss or seek
attention for their chronic pain, it does not mean that they cannot still experience chronic pain. In
fact, it may even be that the conditions which prevent one from speaking out about pain have
some role in inducing the pain in the first place. Chronic pain is not a personality type, as much
as we would like to standardize the chronic pain patient so as to make the unfathomable task of
treating it seem a little less daunting. We must not make assumptions, because that is how
disparities along socioeconomic or ethnic lines are deepened. We must treat each patient as their
own person, and be mindful of the various influences affecting them in life.
With regard to these influences and how they come to define ones life, the information in
all the readings convalesce to elucidate that regardless of the multitude of factors serving as risk
markers for chronic pain, they all seem to converge in each and every chronic pain patient to
produce one universal effect: discontent. I would like to know how many people suffering from

chronic pain are happy with their lives, who find it fulfilling and meaningful. I would be willing
to bet that there would probably not be that many, if any at all. Despite there being a wide range
of psychosocial factors influencing the development of chronic pain, their breadth is irrelevant
when considering that they all serve to negatively influence a persons life in some way. That life
becomes one that is burdened with some degree of suffering, which of course raises the question
of how influential suffering is in chronic pain. We know that pain can create suffering, but maybe
this model only works for acute pain. Since everything regarding chronic pain is opposite to
acute pain, perhaps we should analyze the sources of suffering and how best to alleviate that
suffering before even considering pain. Living with chronic pain can be so debilitating that it can
be considered an illness in its own right, but it might also be true that in the end, pain is still just
a symptom and not a disease; in this case, suffering would be the disease in question.
While there is probably some degree of truth to suffering creating pain, it cannot be
ignored that pain perpetuates suffering. It is not unlike a biochemical model of feedback
stimulation, a process that continually fuels itself. What must be concluded, then, is that chronic
pain cannot be defined by a linear model. For acute pain, it works: a stimulus creates nociception
which is interpreted as pain. Chronic pain is too complex to be stuffed into any sort of model to
aid our perception of it. There would always be some factor left unaccounted for. Its clear that a
biomedical mindset will prove fruitless for treating chronic pain. We need to start treating our
patients as humans, get to know them, and understand as much about them as people in order to
help them.