All pain hurts, so there is a tendency for the super-brave pain sufferer to congratulate himself at "overcoming" his pain. But the truth is that everyone has his breaking point. Pain is an undefeatable foe. As bad as our pain is, we must remember that it may be more severe in others. We should take neuropathic pain patients at their word, that they really must have help, and demand that research efforts are pursued. We should never view neuropathic pain like a hazing, to be endured as others have endured it. Of course, no Central Pain patient would ever view it that way, and those who haven't had neuropathic pain are unqualified to judge. Central Pain is a threat to life. It is an obscenity against humanity. It is a degrading torture. The person is being taken apart, for the nervous system is the person. When the nervous system is a mortal enemy, how can the self survive? Only with the right kind of help. Censure has no place in relating to those whose individuality is dying. 

Fully developed Central Pain can be the worst pain known to man. No doubt many would be shocked to learn that spinal injured patients with some motor ability often indicate they would sacrifice any remaining motor ability if the pain could only be stopped (see studies by Davidoff, Nepomuceno, and Britell). If observers will stop and think about that for a while when gauging the severity of Central Pain, they may be inclined to pontificate less about "keeping a stiff upper lip" and start saying, "We simply must devote the needed funds for research. To do less would be inhuman."

Those whose Central Pain is less severe or partial, especially ones at levels which permit effective functioning, should quit trying to preach the gospel of silent suffering and start getting the message out. They are probably the only ones well enough to become spokesmen for the really tragic cases of overwhelming Central Pain who can only lay in isolation and agony, praying Lazarus-like for someone to give them a drop of relief from their terrible state. Many Central Pain patients spend most of their lives in sedation, emerging from it only long enough to perform the bare minimum of life functions. This is not really living.

The was a famous man who had neuropathic pain, a great and good man, who had great influence nationally, at the very highest levels. He pursued the philosophy of not speaking of his pain, "so as not to burden others", until his death. Undoubtedly he perceived this as the proper way to suffer. But after reflecting on the fact that Dr. John Bonica (the father of American Pain Research, inventor of the epidural block) attributed all his success against pain to being unwilling to accept graciously what Nature had dealt him, I wonder if the tradition of keeping quiet about pain is not as shameful as keeping quiet about any tyranny over the human race.

Is silence courtesy or cowardice? Is silence beneficial or does it merely reflect brainwashing by a society which wishes to devote its resources elsewhere? Aren't the pain philosophies of our society about normal pain, rather than neuropathic pain?

I wonder about this because of the death of people like Bette Lou Hamilton, who seem to feel they cannot measure up to expectations about pain behavior, who cannot work to sustain themselves,  and who therefore cannot maintain life.  I wonder if my acquaintance might not have taken the different route of revealing his suffering and becoming a pain activist if he had looked at it this way. These are not decisions one may make for another, and one must not judge, but my own observations convince me that Bonica had the right idea.