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Inside "Ouch!"

Monday, August 27, 2012 - 07:00 PM

illustration: pain scale Illustration: pain scale (Remixed from CC By-SA 3.0 images from Haragayato; John Dalton; Isabelle Grosjean; Luigi Chiesa; and Sean Lamb/Wikimedia Commons)

Pain is a fundamental part of life, and often a very lonely part. Doctors want to understand their patients' pain, and we all want to understand the suffering of our friends, relatives, or spouses. But pinning down another person's hurt is a slippery business. 

Is your relentless lower back pain more or less unbearable than my crushing headache? Problem is, pain is maddeningly subjective. In this short, producer Tim Howard introduces us to three attempts to put a number on pain in the hopes that we can truly understand the suffering of another.

We begin with entomologist Justin Schmidt's globe-trotting adventure to plot the relative nastiness of insect bites and stings. Then, Paula Michaels, a professor in the History of Medicine at the University of Iowa, brings us back to 1948, to a well-intentioned but ultimately misguided attempt to demystify the pain of childbirth. And we end with a very modern, very personal struggle for understanding as non-fiction writer Eula Biss tries to rate her own chronic pain.


NOTE: Pain Scale image remixed from CC By-SA 3.0 images from Haragayato; John Dalton; Isabelle Grosjean; Luigi Chiesa; and Sean Lamb.

Guests:

Tim Howard

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Comments [70]

Coose6

I really enjoyed this podcast. It was interesting because I've always been interested in pain and how it is actually felt. I liked his realism and bluntness. The shift from stinging to child birth was unexpected. I thought it was interesting how they measured pain.

Apr. 24 2014 03:26 PM

This is an amazing podcast, thanks for sharing! I thought this would be a good place to ask since I've seen there are a few of you guys here who suffer from Chronic Pain.

My name is Andy, I'm a student at Glasgow School of Art in Scotland, studying design with my classmate Tay. We are doing a project on 'the language of pain' and specifically looking into the lives of chronic pain sufferers. After listening to this podcast and reading all your replies we feel it would be fascinating to get your insight on some of our ideas to help chronic pain sufferers:

https://dl.dropboxusercontent.com/u/18463605/Project_Ideas_Pain.pdf

If you are interested or have some feedback please could you email t.kim1@student.gsa.ac.uk

Thanks very much again!
Andy and Tay

Nov. 06 2013 11:06 AM
Laura Wesely from Oakland, CA

This video shows two men going through a "labor pain simulation": http://vimeo.com/65927758

Never having given birth myself does not give me much authority on the matter, however, I do believe that vaginal pain is part of the experience. The two men in the video are merely going through some contractions for merely one hour.

"Ouch!"

May. 16 2013 07:04 PM
Sara from Seattle

I thought I would weigh in on the pain around childbirth. Many of the posters say that if you have your baby in your own home with supportive people and familiar comforts that labor does not have to be painful. Well, I had both my kids outside of the hospital, one in a free standing birth center and another at home. Both times the bulk of the fetal descent happened in a short amount of time and, guess what? It was painful. It was very painful. To have something 14 inches in circumference come out of you, stretching you to the point that you may possibly (and often do) tear, can be a painful experience. It's ok, though, because the pain does end and doesn't return (until you choose to have another kid). Lots of other people have done it in worse circumstances and survived it. After it is over you have a baby and the relief of not being in pain anymore, plus the endorphin high feel really awesome. Still, going through the labor and pushing the kid out were no picnic. There is a reason many women chose to be anesthetized for it and I can't say I blame them. That being said, I LOVED the radiolab segment. I felt those women were speaking the truth.

Mar. 16 2013 04:47 AM
Mike

Listening to this ep w/ my 5 yro daughter. We get to the part discussing child birth, the point where the pain experienced during labor kind of goes off the charts. The woman commenting in the piece said something like "it felt like a freight train being forced through my vagina." I laughed. My daughter did, too, saying "that was funny, that train going through her pajama!"

Mar. 07 2013 10:29 PM
Jennifer Little

I am a Social Security disability attorney. As such, I spend all day every day trying quantify and prove how much pain a person is in. For this reason I was relieved to hear what I already knew to be true. My job is impossible. Perhaps you can better feel my pain from this podcast.

Dec. 12 2012 06:47 PM
ihwang

Excellent piece, as per usual. Does anybody know what music is played starting around 9:14? I think I hear throat singing, and I'd love to find the original track.

Nov. 08 2012 02:56 PM
Amelia from Kittery, Maine

I have to agree with Gwen who posted above, I thought the very same thing! "The Pain Scale" is a beautiful piece of writing which has remained with me since I read it in Harper's in 2005. You must mention it!

Oct. 18 2012 06:36 PM
lisa

There are different types of pain. I have PTSD and the emotional pain comes in waves and is timeless, as described in your labor segment. I compare it to having you skin ripped off and then your dipped in alcohol or gasoline. Its a 10 on the pain scale. My migraines are sometimes like a burning, tingling, dizzying pain like hitting your funny bone.

Oct. 14 2012 11:16 AM
Jeff Martin from Vancouver

For the women experiencing the pain during birth. Were they natural births or induced births? induced births at the hospital are much more painful. For natural births, some women have experienced orgasms during the birth.
American media try to scare women about child birth by saying it's the most painful thing in the world, but that's because of the drugs used to induce labor. Doctors do this to speed to process up because they want to hurry up the process up and go home.

Oct. 12 2012 04:35 PM

I found it so interesting that the woman at the end said she liked the idea of having a pain scale that unites people because it makes her feel less lonely. Last year I was all but diagnosed with a pain condition literally caused by nothing (perhaps like the woman with pain in her neck and face). It was terrifying, but much more so after talking to other people who had a similar thing. I found that I wanted my pain to be unlike there pain (which was debilitating) and chose to stop connecting to people with the same thing. After a year, I've learned to accept the pain, go about my daily life without it ruling me, and I'm still very healthy. On a side note, my worst pain occurred when I fell into a deep depression. As my mental health improved, my pain lessened. I don't think that's a coincidence.

Oct. 10 2012 08:36 PM
Rayner Garner from London UK

If you are in labour, and the survival fear or flight syndrome has been activated, adrenaline is being produced by your body. Adrenaline is an energy producing drug, designed to give one the energy to fight or flee.

Now to relax or deal with this energy by any other means, than by exercise will only cause more pain not less. Dance with a partner for about 20 minutes or some other activity such as beating a large pillow enthusiastically will also work. Adrenaline in your body is a call for action not relaxation.
raynergarner.com

Oct. 10 2012 09:15 AM
Heather from Toronto, ON, Canada

I really enjoy your podcasts in general and I liked this one in particular. One thing that I felt was misrepresented though was the findings of Grantly Dick-Read regarding pain in childbirth. He did not state that childbirth *is* painless or that the pain women experience is "all in their heads". What he found was that childbirth *can be* painless (something we know to be true) and that a woman's experience of pain is directly connected to her emotional or psychological state. What he found was that women who were not afraid of childbirth (usually encountered in other cultures where birth has not been routinely medicalized) and who were not made to feel frightened or anxious during childbirth were much more likely to experience a painless childbirth. This finding is supported by what we know of the brain chemicals that are released during labour. If a woman is unafraid of childbirth (a rarity in our culture today, given how we are trained to view pregnancy and labour as pathological) and if she is treated well during labour (with dignity, respect and love) and has privacy, quiet and dim lighting, her body produces incredibly high quantities of endorphins - which are as much as 10x stronger than morphine in terms of their painkilling capability. On the other hand, if she is afraid of childbirth, if she is made afraid during childbirth (how many people fear hospitals, needles, etc.?), if she is treated poorly, feels exposed and is subjected to a battery of tests and indignities, her stress hormones - catecholamines, such as adrenaline and cortisol - rise and suppress the release of those endorphins. This means that she experiences all of the normal processes of childbirth as pain. It also slows labour down (we are mammals - if a deer in the woods is in labour and she senses a predator, her cervical dilation will slow down, stop or even reverse itself; this is no less true for humans who are stressed during labour).
Labour is not a thing that can be controlled and the sooner we learn that and respect the power of women's bodies and their ability to give birth, the sooner women everywhere will be treated fairly, the world over. I do not wish to suggest that I am opposed to Western medicine - when there are naturally occurring (as opposed to iatrogenic) complications or when a pregnancy or labour is high risk (this is less common than we generally think), there are excellent medical technologies and procedures that can save the lives of mothers and babies.
The WHO states that the safest place for a woman to give birth is in the home with a trained birth attendant (i.e. a midwife). Hospitals are useful for many things and necessary for some labours, but we are doing a grave disservice to women and babies by perpetuating the belief that all women are better off birthing in a medicalized, uncomfortable and anxiety-producing environment.

Heather Neville
Certified Labour Doula & Childbirth Educator
www.labourdoula.com

Sep. 24 2012 09:40 AM
Lorri Cornett

One day when my son was around 13 or 14, he wondered aloud: What if all the pain in someone's life waited and was saved up so you felt it all just before you died? Something to think about...

Sep. 20 2012 09:38 AM
Josh from Korea

"Ouch! The Language of Pain" on NPR

http://www.npr.org/templates/story/story.php?storyId=1385022

Sep. 17 2012 11:38 PM
MLinTN from Nashville, TN

I thought this was another interesting experiment (or experitainment, in this case) -- a man tests his pain threshold against the labor pains of a woman by having his abdominal muscles stimulated to contract at the same intensity, frequency, and duration as labor pains.

http://www.youtube.com/watch?v=6AdFdmE9A84

Sep. 14 2012 04:20 PM
fltymknzm from VA

Why can't doctors measure the brain waves, isolate the output of the area in the brain that measures pain, measure that activity and use that as quantitative data? I'm not a neurologist but I'm guessing the more activity, the higher the pain level. There's got to be some kind of output that can be measured as the disruption of pain.

Sep. 13 2012 07:13 PM
Devin Carless

I've done some thinking about how we measure pain. Generally, when I am in pain, I don't measure it against my memory of previous suffering because I usually have little clear memory of what I felt. Instead, I try to gauge what kind of pain I am in by how much of my attention it consumes, and to what lengths I'll go to get away from it.

When I had a pneumothorax, a chest tube was inserted between my ribs to drain the fluid after the lung had been reinflated. It hurt every time I breathed. I was given Demerol every four hours...but the shot only lasted for two and a half. I would stop my breathing just so I had a few seconds where the pain was less - but I could still, even at the time, imagine worse. I didn't want to talk or be friendly with the volunteer taking me to X-ray.

Sep. 13 2012 03:17 PM
Sarah from Las Vegas

Listening to this and the problems with quantifying pain made me think of a book called "The Illumination" by Kevin Brockmeier. In the book, pain radiates as light, so everyone can see exactly how much pain you are in. Interesting concept to think how things would be different if pain was no longer subjective.

Sep. 13 2012 12:33 PM
FlatulentTheropod from Brooklyn

I had a very similar experience to the woman in the show in that I once went to the hospital in a great deal of pain--pain that I would now categorize as a 7 or 8--but when asked to rate myself on the pain scale, which I had never done before, I imagined the worst possible pain as something like being a cancer patient undergoing chemotherapy while being burned at the stake, so I said "2." I mean, I was nowhere near that. I've since come to a personal understanding of pain that helps me make great sense of the scale--one which the less pedantic people in the world seem to understand intuitively, but which formerly escaped me: The pain scale is not linear, but logarithmic. The chemo patient burning at the stake may be a 10, but I can still be an 8 for a broken ankle because I'm not two rungs down the ladder, but rather 100 times less in pain. Decibels, earthquakes and pain and logarithms.

Sep. 12 2012 10:34 PM
Bronwen Stine from Brooklyn

Yep, yep, yep -- another mom here to tell you that my experience with childbirth (two times without medications for pain or otherwise) was certainly NOT the most painful thing I've experienced. That honor goes to crossing the Continental Divide in a Volkswagon mini pickup while having a bad ear infection when I was 14. That was MUCH MUCH worse than childbirth.

But what others have said is also true, namely that childbirth pain has a completely different character from other pain. It's more like the pain of pushing past your own perceived athletic limitations, and not AT ALL like the pain of a burn to the skin! Before I had kids, I also wondered how I would respond to childbirth. I don't encounter pain on a regular basis (thank goodness & knock wood!), so I didn't know how I would handle it. But it turns out that, for me, anyway, it was not so bad. It was hard work, but joyous, even in the moment. Recommended reading for anyone anxious or curious: The Thinking Woman's Guide to a Better Birth by Henci Goer.

Sep. 12 2012 05:32 PM
soupy

Interesting short. I agree with the user who wrote that there's something missing in the conversation about childbirth. As a woman who has never given birth but wants kids, I was freaked out. I was thinking: At what point, if any, did these women ask for an epidural? Were these natural births or what? If these women had multiple children, was each birth so painful? So I guess Jad and Robert's wives are right: they are so clueless about childbirth pain that they let it sound really scary without adding an alternate perspective :). I mean I'm a radio producer and I suppose even with these web shorts there's a time limit or at least a concern, but I would have appreciated a little more explanation.

As a pain sufferer, I completely understood the womens' "resorting" to weird metaphors. I have horrible pain in my pelvic floor around my periods. Another woman described this as being like "Giving birth to demons," and I thought that was a pretty good descriptor. To get my point across I usually describe what the pain does to me physically or psychologically, like "I had to lie in bed with a heating pad almost all day" or "I went to work but I couldn't concentrate on more involved tasks," or "I lost my mind that day and started throwing almonds at the birds in the backyard, trying to hit them" (true story).

On an up note, when I told my doctor that I thought I no longer ever wanted to have children because I didn't want to experience any pain worse than this, particularly in my pelvis, she said childbirth does not have to be as bad because you can get an epidural.

What would I give up to get rid of the pain? A terrible haircut? In a heartbeat. I'm a bellydancer, (not professional), and I would give up dancing ever again. Five years off my life, ok. I thought about: would I give up the memory of my first love? No, I don't think so. Though I'm only at about a 2.5 right now.

Two weeks ago I started a medication called Lupron which lowers my estrogen, inducing what they call "medical menopause," so that I can stop having periods for a few months. For a few days I have been very depressed, which is a side effect. The pharmacist said that most women have symptoms like depression and mood swings fade after the first month on the drug. But what if this isn't the case with me. Then I might be faced with the question: is it worth trading physical pain for emotional misery? I'd be curious to see if anyone has a similar experience, and what they concluded about the trade-off.

Sep. 11 2012 02:07 AM
Joel Pierce from Konxville

I have had a CONSTANT chronic headache for the past 5+ years, I'm approaching 2000 days of nonstop pain. I suffer from cluster headaches in the spring and have migraine / hemicrania continua type symptoms but no treatments have been effective. I have been on over 110 medications not counting those prescribed during my 6 hospitalizations.
Yesterday I was making some iced tea. I was in a bit of a rush so I let the tea boil longer instead of steeping. I poured the fresh off the stove tea over the ice in the tea pitcher and my hand slipped. The hot tea poured completely over my left hand. I was surprised, I didn't scream or even cry out. I felt the sting on my hand and a chill ran over my head. I ran cold water over my hand, got a fresh pitcher of ice water and kept my hand in ice for a while and a little something reserved for headaches.

Today A few blisters but no hand pain. My head hurts as usual, my daily pain is a 7 which spikes to a 8 to 9. I get "attacks" that can hit a 10 that completely "shuts me down"

I guess my headache has caused my pain threshold has to increase from other types of pain. The boiling water really didn't hurt.

To the question what would you give up to get rid of your pain. I would gladly give my legs or an arm for this headache to stop. I however would not give a day or second of my life for the headache to go away. Every second with my family is worth the pain even if it were to go up to a 9 daily (God forbid)

I can't wait for the next 2 episodes in this series Thanks for doing it. People with chronic pain can not really be understood unless you have lived it. Chronic pain is truly a different animal.

Sep. 09 2012 04:09 PM

Love you guys but I have to disagree on the labor pain. I had a root canal while pregnant with my second child and before the dentist could treat me I endured lot of pain, continuous throbbing pain. The anesthesia used had to be very low due to my pregnancy so it kept wearing out, yeah more pain!

Contractions during labor? bring it! They are spaced apart and you can actually take a moment to breath and compose yourself while waiting for the next one. And at the end of this you have a baby in your arms, not a bottle of pain medication to pop in your mouth every few hours to stop the pain.

Sep. 07 2012 11:46 AM
Jazmin

I love radiolab but I find myself really upset after listening to this short. I think you have done a great disservice to women by frightening them about childbirth. I have given birth twice, both times at home, naturally, with no pain medication. I did not find birth to be painful, but rather I found it to be overwhelming, very intense, and ultimately extremely empowering and wonderful. I look forward to birthing again.

Pain is a word I associate with things being wrong, with broken bones, stabbings, dislocation, etc. Birth is a natural and healthy process and should never be grouped with injuries. I hate that you did not include this perspective and rather used a ridiculous and debunked pseudo-scientific study comparing contractions (the body's normal process) with burns (unnatural injuries.)

I believe that fear plays a not insignificant role in the experience of pain during birth. Considering that this episode has perpetuated the fear of birth so prevalent in our culture, I fear you have caused unnecessary pain for listeners who go on to give birth.

Please, please, if you are a pregnant woman reading this, do not believe that birth is always painful. Trust your body and its ability to carry you through this natural, healthy experience.

Sep. 07 2012 01:12 AM
Nicole from MA

As a surgical nurse, I deal with the pain scales all the time. My usual patients are fresh post-ops and so pain is a huge topic of conversation between us. One of the most annoying things that patients do is say to me "Oh, I need my (insert drug of choice - usually Dilaudid) right now. I'm an 8/10. Also, I need a soda because already drank my first soda with my cheeseburger five minutes ago." If you're an 8/10, I'm thinking maybe you shouldn't be able to thinking about drinking soda and eating cheeseburgers.

Pain was defined in 1973 as "Whatever the patient says it is" by Margo McCaffrey. I just wish there was an easier way of explaining it to me as the nurse. I personally have suffered three broken bones, including a broken leg, which I remember being painful but I don't honestly remember what the pain felt like. So it is rather useless as a reference.

Sep. 06 2012 12:07 PM
evierynk

do you guys know there seems to be a glitch with the podcast download through itunes? the first few seconds work and then either it won't play or it sounds like gobledy-gook. hope there is a way to fix it, i would like to listen it on my walks to and from work. i am TA-ing a class on the senses and this may be a good resource for our section on how we sense pain.

Sep. 05 2012 03:26 PM
Tristan E from San Francisco, California

When I was 18 I contracted a Staph infection which ended up infecting 3 different parts of my body, one of them being my sciatic nerve. Nerves are the things that FEEL pain and, as far as I understand, the sciatic nerve is one of the biggest nerves in the body. This infection left me in the hospital for 2 weeks, in bed for a month and very nearly killed me.

The pain I remember feeling was the most excruciating thing I could imagine. I thought about how a gunshot would feel or how it would feel to have a leg amputated the old fashion way and couldn't even compare them. Those pains seemed to me somehow escapable and external, whereas the pain I was feeling was a constant, it was coming from inside me and was unrelenting. My body had been turned against itself, and what better to inflict pain on yourself than your own nervous system? The doctors gave me morphine and a slew of other drugs that didn't help the pain at all until we tried large amounts of dilaudid injected straight into my bloodstream which effectively made me not realize or care that I was even in pain only if I didn't move at all, although I somehow still was in pain and immobile.

I was asked multiple times over the first 3 weeks to rate my pain on a scale of 1-10 and as the infection got worse my ratings went up and up until I was at a point that I couldn't even talk, couldn't even concentrate or come up with more than a loud moan. I have no doubts that pain is relative but I think the end of the pain scale is when you can't even formulate an answer because you're in so much pain.

Sep. 05 2012 02:54 PM
Phil

Pain hurts. Chronic pain is another game. In my experience sufferers of chronic clusterheadaches rarely discuss the measurement of pain.

The 1-10 scales which attempt to measure pain according to a sufferer's reaction have a silent number 11: I killed myself.

Sep. 03 2012 03:14 AM
victor

The woman with the mystery symptoms is suffering from occipital and trigeminal neuralgia. It is known as one of the most painful disorders in medicine. There is no known cure but, electrostimulation from nerve stimulators and wires placed on the nerves of the neck and face can block pain signals. I should know as I have two implanted pacemakers and wires covering my left quadrant up into my facial nerves.

Sep. 02 2012 01:33 PM
Phil from Baltimore

I have a sense that pain doesn't fit on a scale well. Yet there are qualities of pain that we can all agree on and share. It's not possible to say that one quality is "twice as bad" as another, but it would be interesting to see if most people agree to the order of the following:

- I feel fine
- I can feel something, but it's not pain
- I can feel something as pain
- The pain is affecting my behavior (limp, etc)
- The pain is dominating my behavior (can't get out of bed, etc)
- I think I'm going to loose my mind if this continues
- I would kill myself to end the pain

The quality of pain can change, even if the subjective(?) level of pain remains the same. Pain that starts out incapacitating can become bearable. Moderate pain can recede to the background and no longer affect behavior, but still be there. The reverse can also be true - a barely detectable pain can become incapacitating if the cause is determined to be cancer, for example.

Sep. 02 2012 07:53 AM
Massih from London, UK

I have to say I usually love RadioLab & I get very excited when I see that there is a new episode. The timing of this podcast is actually sort of perfect because it was released on the last day of the International Association for the Study of Pain's biennial conference. However, the podcast was really disappointing. I usually love that you cover the science and tie in personal experiences... But in this episode, there was too little on the proper science of pain scales. There is a huge literature on these, and an even bigger literature describing why pain is so variable. Sorry to have to say that I am not as happy with this one as I am with other Radiolab episodes.

Sep. 02 2012 04:32 AM
xrayguy from Omaha

I work at a medical clinic and part of our checkin procedure is to ask people "how much pain are you in now, on a scale from zero to ten". This is evidently the hardest question in the world to answer. First, they start out "well, YESTERDAY it was..." NO, not yesterday, now, here in the room. Then "Which is highest?" Its a freaking "zero to ten" scale, zero means zero, nil, nothing! Ten is always the highest! What is so hard about this? Next,"Oh, it's a ten!" This is after they walked into the exam room under their own power, made converstation with me, cracked jokes in the lobby with other patients. I associate a ten with "about to pass out from pain, unable to function".
If someone STILL doesnt get it, I try giving them examples "A ten is like childbirth, a broken femur, kidney stones".
"Oh, I've never had any of those".
It is at this point, I am about to offer to SHOW them what a ten score is.

I associate the scale like this
0, no pain
1-2, so little it only hurts if I think about it
2-3, hurts, but I can ignore it and live
3-4, kind of pushing back at me
4-5, really pushing back at me, keeping me from doing things
6-7, wakes you up at night, cant do things, need meds
8-9, cant work, trouble functioning daily level,need meds
10-, pass out
Thanks guys, I always enjoy the shows

They still dont get it "Oh, I've never had any of those"

Sep. 01 2012 09:57 PM
Lori from DC Metro Area

Ouch!is a quick jab. Pain...it's a mix of duration and intensity. My elderly father was about to undergo a procedure to flush his bladder, due to an infection. He was resisting, as he knew his extreme pain experienced from this previously. The medical attendant was insistent.

I gave him my hand and said that he could squeeze it while the procedure was taking place. I might not ever make that offer again! Pain times 2!!(Perhaps the doctors who prescribe it should make this offer instead!?)

Sep. 01 2012 07:07 PM
Tina from Oregon

This episdoe wouldn't play through itunes at all, except for the introduction. I came to the website to listen to it.

Aug. 31 2012 10:32 PM
nycues

Only the voices came across in the Jabba the Hutt voice, the background sounds seemed to be normal. It synched to my ipod but now it won't play from my Mac. All very weird... do you guys have a disgruntled intern?

Aug. 31 2012 08:46 AM
Colleen from Long Island

My download was also garbled....very creepy.

Aug. 31 2012 12:06 AM
Antonia Murphy from Whangarei, new zealand

Two thoughts on this excellent podcast:

1) The cause of the pain impacts our perception of it. I could hang on during natural childbirth because I knew I was just going through a natural process that women had experienced for thousands of years. If I had felt the same sensations during a car crash, I would have been sure I was DEFINITELY going to die.

2) our prior experience of pain-- and even our cultural context-- impacts how we perceive it. When I was on a varsity women's crew team in my 20s, I and my teammates had to chase after and deliberately prolong pain in order to be better athletes. As coddled college girls, this was a first for us: mommy and daddy had always scooped us up and comforted us when we hurt. But the experience of being an athlete made me tougher, and i was able to access those reserves of strength when I gave birth 15 years later.

Aug. 30 2012 11:09 PM
Gwen

As soon as I saw the topic of this episode, I thought "they have to talk to Eula Biss." So it was VERY exciting to hear her interviewed, but I was disappointed that there was no mention of her short nonfiction story on the topic, titled "The Pain Scale." It's brilliant. http://blog.lib.umn.edu/puot0002/queerethics/HarpersMagazine-2005-06-0080588.pdf

Aug. 30 2012 06:14 PM
bdboardman from phoenix. az

I'm not sure if it is just me, but I downloaded the podcast and all I got was a really slow, garbled, warble...

Aug. 30 2012 02:14 PM
iben from Copenhagen

THNX for yet an other fantastic podcast.

The whole concept of measuring pain is interesting, because we have to take in to consideration that physical pain is can be increased and decreased with ones metal state.

Women who give birth at home and midwives that help these women, talk about less painful births -because they feel safe and secure in their natural comfort zone. I'm one of these women and I experienced tow painless births -so I'm a women that believes that some women feel pain while giving birth because of the angst surrounding the experience.

I'm now sick with an illness, giving me daily pain -meaning I wake up with pain, I have pain threw out the day and evening and wake up in the middle of the night with pain. The doctors can not find the course and can not give me a diagnose. I feel that having ongoing pain is worsens how strong the pain feels, simply because having to deal with pain 24/7 is completely exhausting and gives you no strength to overcome the next session of pain. After this follows an angst for what the future might bring -or might I say what restrictions will this illness put on the rest of my life.

I would like to hear peoples experience with pain + angst + ongoing what scale is this? If any.

Aug. 30 2012 01:56 PM
R. from Washington, DC

Ten thumbs up to Christy for beating me to posting Allie Long's "Hyperbole and a Half" Better Pain Rating Scale! That was the first thing I thought of when I heard this episode's topic. I've actually printed her scale, complete with accompanying descriptions -- and stored it in my "Emergency Medical Info" folder (you know, the one no one will ever actually find in an emergency because you'll be unconscious and won't be able to tell anyone where it is, and yet somehow, having one makes you feel like a responsible adult anyway. Yeah, that one) just in case it might come in handy. As subjective as pain is, having a scale to reference solely for the purpose of communicating the level of pain RELIEF one needs is actually really handy. I'm not even sure it matters at that point that pain can't (yet) be objectively quantified. Just my two cents -- thanks for yet another amazingly entertaining and thought-provoking episode, Radiolab!

Aug. 30 2012 10:10 AM
Karl James from London, UK

Loved this Short. Thanks Radiolab. A beautifully etched portrait as ever. Can I modestly recommend to anyone interested in audio on Pain they check out The Dialogue Project's podcasts on this subject: deeply personal and intimate conversations on the subject with people who know first-hand what it is to experience and describe pain (and in some cases) pleasure. Three titles in particular: 1: When I Saw Myself on Fire, 2: Four Strokes and 3: How's Taegen? You can listen to them all at http://itunes.apple.com/gb/podcast/2-2-5-the-dialogue-project/id423791414

Aug. 30 2012 01:44 AM
Edgar from NY

Great episode; loved the lightness and humor. Will be saving this one for playback

Aug. 29 2012 10:29 PM
Bianca from Cincinnati, OH

I was surprised you didn't interview Melanie Thernstrom, author of The Pain Chronicles for this episode. If you ever decide to expand it to an hour, she would be a great person to speak with.

http://melaniethernstrom.com/painchronicles.html

Aug. 29 2012 06:39 PM
mark

...only second degree? Sheesh, I knew it: just a bunch of faking.

Aug. 29 2012 12:07 PM
Christy

Having given birth only twice, I can see how pain is difficult to measure. Both pregnancies and labor were so vastly different from each other I wouldn't know how to quantify them, other than comparing them to each other. My first birth was much less painful than my second birth, however the second one was faster.

Oddly enough (and humorously enough) I think hyperboleandahalf has the best pain scale online. Even though this was done tongue and cheek, I think it's a much better representation of how to describe pain than the one in the doctor's office.

http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html (the drawing really makes the scale).
0: Hi. I am not experiencing any pain at all. I don't know why I'm even here.

1: I am completely unsure whether I am experiencing pain or itching or maybe I just have a bad taste in my mouth.

2: I probably just need a Band Aid.

3: This is distressing. I don't want this to be happening to me at all.

4: My pain is not fucking around.

5: Why is this happening to me??

6: Ow. Okay, my pain is super legit now.

7: I see Jesus coming for me and I'm scared.

8: I am experiencing a disturbing amount of pain. I might actually be dying. Please help.

9: I am almost definitely dying.

10: I am actively being mauled by a bear.

11: Blood is going to explode out of my face at any moment.

Aug. 29 2012 10:39 AM

What about a pain scale based on physiologic responses such as crying, perspiration, blood pressure (guess you would need a baseline for the person), tremors, restricted ability to move? These are all signs that someone is in distress. While we couldn't know for sure that the pain causing the person to cry is the same as pain that is enough to make us cry, we could be sure that that person was in significant distress. Has anyone tried to create a scale based on such physiologic responses?

Aug. 29 2012 09:05 AM
Mark from Boulder

I thought this was so much fun, I will be saving this one forever. Knew it couldn't be intentional, it required just a little too much attention span to follow. Reminded me of the one with sprinters and the 24 hours of Beethoven.

Aug. 29 2012 08:10 AM
Michael Bonner from McClellanville, South Carolina

When I was in the hospital for colon cancer surgery, I got asked about the pain scale so often that I had a friend print out this XKCD cartoon, which I think was pretty new at the time, and bring it to me to show the nurses:

http://www.xkcd.com/883/

I wish I'd known about this one, just because it's so much more graphic:

http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

But really, on either scale, I wasn't so bad off. The drugs did a very good job.

Aug. 28 2012 09:33 PM

@bfarrell mplayer indicates that the audio data abruptly changes from 1-channel (44100Hz 1ch floatle) to 2-channel (44100Hz 2ch floatle). The front matter needs to be replaced converted to 2-channel data.

Aug. 28 2012 01:16 PM
Nicholas Young from Chicago, IL

I downloaded the episode yesterday when it dropped with Instacast on my iPhone. Playback was slow, and the audio distorted.

But, when I visited the site and started playback here, everything was fine. Great show!

Aug. 28 2012 01:15 PM

Hey everybody, sorry for the audio weirdness -- we're having some technical troubles. You can stream the podcast here on our site while we work on the issue! More soon...

Aug. 28 2012 01:02 PM
Ms. from NYC

I'm having no problem with the speed or clarity of your pod-casts, and enjoy them very much indeed. This one is close to my heart, as I've experienced many episodes of intense pain over the seven decades of my life, from swollen tonsils, mumps and measles as a child, through the crippling effects of an infected knee after a fall on rocks in my twenties, various difficulties with lymphatic cysts (one persistent one being surgically removed, and a terribly painful episode of shingles in my late forties (apparently brought on by stress factors at the job I had then),and which defied medical interventions until I found a homeopathic MD who did cure it.

The worst perhaps was an infection (in my 30's) brought on by the amorphously labeled "Pelvic Inflammatory Disease" that landed me in the hospital with a surgically implanted drain, and a high dose of a broad spectrum antibiotic being dripped into my bloodstream for ten days, with a month following that for recovery with bed rest at home. I do not remember the pain specifically, but I do recall that at the onset, I would have gladly checked out of life altogether to be relieved of it. I am now grateful I did not have that alternative offered. I would have taken it then.

Aug. 28 2012 12:59 PM
Zaid from Kuwait

Yeah the podcast only lasts for 6 seconds and then cuts out completely. If I download it from iTunes or through the website I get the same issue. It only seems to work by streaming from this website itself. Interesting topic, can't wait to get to hear it.

Aug. 28 2012 12:39 PM
Jeff

downloaded from iTunes, the file won't play past "You can find all our other shows at radiolab.org Stops.

Aug. 28 2012 12:15 PM
ben

Man, I was kinda hoping the slow-down thing was intentional...

Aug. 28 2012 11:41 AM
Tony from Ames, Iowa

Having the slowed-down problem like everyone else, but not just with this podcast. Having the same problem when I try to listen to older stories, too. Excited to hear about Pain when it gets fixed!

Aug. 28 2012 10:28 AM
MB

Another person with a slow audio problem - Downloaded with Android Listen app - unlistenable.

Aug. 28 2012 10:27 AM
Rob C from VA

Pain...funny...maybe this is part of the lesson

Aug. 28 2012 10:21 AM
Stephanie from Amarillo

At first I just thought it was Jad playing with sound again!

Aug. 28 2012 10:18 AM
Steve from Grafton, WI

Thought it was a problem with my double speed playback. Not that I EVER listen to Radiolab at double speed.

Aug. 28 2012 10:12 AM
Rob

Intro is at the correct speed then it goes to slow. Downloaded with Dogcatcher on Android device.

Aug. 28 2012 09:59 AM
JT

From the sound of the podcast, it seems demons have possessed Jad and Robert... Any exorcists out there? :-)

Aug. 28 2012 09:45 AM
Christine

Podcast not working

Aug. 28 2012 09:19 AM
ryan from MD

Is playback speed PAINFULLY slow for everyone else?

Aug. 28 2012 09:11 AM

Yep, broken for me too.

Aug. 28 2012 09:11 AM
alex from st paul, mn

When I download it, the sound is not right. Very slow and too low. anyone else?

Aug. 28 2012 09:09 AM
Mike Lawrence from Halifax, NS, Canada

The audio file is broken, both here and in the radio lab app. The sound stops after a couple seconds. Such anticipatory agony!

Aug. 28 2012 08:55 AM

Pain is so subjective it's absurd. For many human experiences there is some kind of empathic baseline. Everyone knows the feeling of standing on a diving board for the first time. The pit in your stomach and the strange compulsion to throw yourself off, right up until you get to the very edge...

Everyone knows what looking at the sun briefly feels like, since when your mother told you not to do it, that made it an irresistible temptation.

These are minor, and specific benchmarks. And even these vary to an extent. Some people aren't afraid of heights, even a little and had no compunction jumping off a diving board for the first time (although this kind of human Nyad rare). There is variability in the range of pain for mild gastric distress: Someone who's had appendicitis is likely to rate pain from gastric distress lower in general, since they had such a painful appendix that they ended up in a hospital, at a gastroenterologist, or went to their GP.

Pain is both a matter of internal thresholds, as well as relative ratings compared with prior experience. For instance, during a bout of deep depression many years ago, I developed a habit of burning myself with wire brands, and that became an almost erotic experience. The pain stopped very quickly, and became sensuous, even after adequate treatment. For other people a piece of metal heated to only 120 Degrees Fahrenheit is unbearably painful.

My point is, pain is a holistic phenomenon with many aspects in human biology, neurology, psychology and pharmacology, and needs to be rated and addressed as such.

Aug. 28 2012 03:18 AM

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