• Ashwin Prakash

On pain, performance and principle


Image by Christos Giakkas from Pixabay


One evening earlier this year, I was walking up an escalator at a metro station when I tripped, and my right kneecap squarely struck the jagged step ahead of me. I hobbled up to the platform, acutely aware that my numb knee and dark pant leg rapidly turning russet brown portended a wholly discomfiting trip home. However, in that moment my mind darted not to concern for my injury, but to relief that it appeared no one around had witnessed my stumble. Luckily, I had supplies in my backpack with which I could luckily dress my wound in relative privacy. I ultimately spent the next two weeks acting to conceal the pain I felt with the slightest bend to my knee.


Looking back now I ask myself, why was I so eager to prioritize hiding my pain over maintaining comfort and safety? Why do I find it difficult to recollect the physical sensation of that pain and yet I vividly remember how it influenced my behavior? And why does masking what is inside feel like second-nature?


In answering these questions, I recognize that this particular episode of my life was just that: an episode. Nursing a minor injury over two weeks does not begin to scratch the surface of encapsulating the serial experience of living with chronic pain. Globally, one in five adults lives with chronic pain [1]. The continual need to address the physical cost of pain surely interferes with activities of daily living. Add the difficulty of accessing potent treatment options that minimize the risk of negative side effects, and the prospect of enjoying life seems out of reach. With respect to interacting with the people around us, pain is a “constant companion,” a recurring player [2]. In Pain as Human Experience, Paul Brodwin details the case of a woman whose chronic pain influences her social relationships in a way that how she handles her symptoms in different situations resembles a performance. Her pain serves as a language with which she communicates her feelings to her family and friends [3]. Whereas in my case pain was merely a guest player, for those with chronic conditions, pain enters and exits so often it practically always feels center stage. Both cases, however, illustrate the role of performance in coping with pain.


The notion that we perform in our daily lives is not novel. When Shakespeare wrote that “all the world’s a stage,” he captured the ephemeral nature of a single life, demarcated by the roles we play in society [4]. Erving Goffman explained peoples’ daily interactions through his dramaturgical theory in which he detailed how we manage impressions that others have of us when forming our identities in public [5]. As we retreat into our private spheres, we are able to shed the fronts we wear. But in the context of pain, the tendency to mask when interacting with others poses challenges for finding relief.


Some would say that pain is an inevitable part of life. Pain is not only physical, but mental as well. We all experience pain in its various forms. But if all life is suffering, what is the point? The scripts of our lives, despite the prevalence of pain, need not be punctuated by loss and the inability to connect. If we felt less compelled to perform, then we and the people around us would better understand each other. Perhaps an effort to break down the walls between our private and public selves would transcend the inevitability of performance. In the end, we must not let a dearth of optimism outweigh the strength of hope. For those with pain, we must say that you matter, even if someone else says otherwise. After all, to live is to work to reduce the suffering of those around us. This is easier said than done, but together we can work to push pain to the wings of our world’s stage.



Sources:

  1. International Association for the Study of Pain: Unrelieved pain is a major global healthcare problem. https://s3.amazonaws.com/rdcms-iasp/files/production/public/Content/ContentFolders/GlobalYearAgainstPain2/20042005RighttoPainRelief/factsheet.pdf

  2. Collier, Roger. “A short history of pain management.” CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne vol. 190,1 (2018): E26-E27. doi:10.1503/cmaj.109-5523

  3. Brodwin, Paul E. “Symptoms and Social Performances: The Case of Diane Reden.” Pain as Human Experience: an Anthropological Perspective, edited by Mary-Jo DelVecchio. Good et al., University of California Press, 1994, pp. 77–99.

  4. Shakespeare, William, and Horace H. Furness. As You Like It. New York: Dover Publications, 1963.

  5. Goffman, Erving. The Presentation of Self in Everyday Life. New York: Anchor Books, 1959. Print.

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