PAIN
Pain is one of the very hard things of life which most people find it
extremely difficult to bear with equanimity. I suppose that the
majority of human beings, especially when they are young, do not feel
nearly so much dread of death as they do of the possibility of years
of discomfort preceding it or even a short period of very acute pain
when nature is preparing for dissolution. Older folks learn to bear
physical pain better and come to appreciate how much harder to stand
is mental anguish. Modern life, with its cultivation of comforts and
conveniences and the elimination of discomforts of all kinds, has
greatly fostered the dread of pain. We hear much of the progress of
humanity founded on the increase of comfort, but that way lies
degeneracy and failure to take life seriously. Human character
develops under the stress of pain and even the body acquires
self-control through it and is trained under the discipline of pain
not to react so disturbingly as is the case when there has been no
experience with it or but very little.
We find it almost impossible to understand, now that we have
cultivated the comforts of life so sedulously, how men and women stood
the discomforts to which they were subjected in the ordinary run of
life practically every day two generations ago. A great many of them
slept {266} in little stuffy attics with scarcely any chance for the
free movement of air on the hot days of summer, often immediately
underneath a roof which had been exposed to the direct rays of the sun
all day long. In the winter not infrequently they broke the ice in
their pitchers to secure water for washing. Their heating arrangements
were so imperfect that in the colder months at least there was very
little possibility of comfort. A grate fire makes a very charming
ornamental addition to a room which is heated by steam or some other
modern heating arrangement, but when it is the only means of heating
it is not very efficacious except in milder weather. On very cold days
an open fire will heat one side of the individual, but not the whole
person, and at best the feet are likely to be cold because the open
fire must be fed with an abundance of air and the draft runs along the
floor in order to get to it. The story is told of an English public
school in the old days where the head master met one of the smaller
boys crying because of the cold; on being told what was the matter,
the head master simply remarked that "this was no young ladies'
seminary, and young gentlemen are expected to stand things without
tears." Twenty years later in India, during the Mutiny, just before
that boy who had cried from the cold led a forlorn hope of a charge
with the idea of saving the lives of women and children, he remarked
to his commanding officer who was himself also from that same public
school, "This is what old... "--naming the head master--"would have
said is no young ladies' seminary." And then he went out without more
ado to accept death in a great cause.
It is extremely difficult for us to understand how the people of the
older time, young and old, endured all these {267} trials and
hardships, though it is not difficult to comprehend that if one were
exercised daily in standing things of this kind it would be much
easier to bear pain and even serious discomfort than it is at the
present time, when many people can bear only the touch of silk on the
skin and the sybarite's complaint of his utter inability to sleep
because there was a crushed rose leaf underneath him has become almost
a literal reality. More and more we are eliminating discomforts from
life and making things as comfortable and easy as possible. From the
carefully tempered water of the morning bath to the warm foot bath
just before sleep, in a bedroom where the temperature makes it
possible to undress for bed without a shiver, all is arranged for the
avoidance of the slightest discomfort.
Pain has become a veritable nightmare to most people as a consequence
of the lack of the necessity to stand things in life, and it is
therefore all the more interesting to see what an effect religion can
have in enabling people to stand pain. In my volume "Health through
Will Power" I have told the story of the second last General of the
Jesuits and the very serious and intensely painful operation which he
insisted on standing without an anaesthetic. The story is worth
repeating here as showing what a habit of prayer and practice of
self-control can do for a man in the face of some of the severest pain
a human being is asked to stand. Generals of the Jesuits have usually
found their way into literature for very different reasons from this.
He had developed a sarcoma of his upper arm and was advised to submit
to an amputation at the shoulder joint. As he was well on in the
sixties the operation presented an extremely serious problem. The
surgeons suggested {268} that he should be ready for the anaesthetic
at a given hour the next morning and then they would proceed to
operate. He replied that he would be ready for the operation at the
time appointed, but that he would not take an anaesthetic. They argued
with him that it would be quite impossible for him to stand
unanaesthetized the elaborate cutting and dissection necessary to
complete an operation of this kind in a most important part of the
body, where large nerves and arteries would have to be cut through and
where the slightest disturbance on the part of the patient might
easily lead to serious or even fatal results. Above all, he could not
hope to stand the exaggerated pain that would surely be produced in
the tissues rendered more sensitive than normal by the increased
circulation to the part, due to the growth of the tumor.
He insisted, however, that he would not take an anaesthetic, for
surely here seemed a chance to welcome suffering voluntarily as his
Lord and Master had done. I believe that the head surgeon said at
first that he would not operate. He felt sure that the operation would
have to be interrupted after it had been begun, because the patient
would not be able to stand the pain, and there would then be the
danger from bleeding as well as from infection which might occur as
the result of the delay. The General of the Jesuits, however, was so
calm and firm that at last it was determined to permit him at least to
try to stand it.
The event was most interesting. The patient not only underwent the
operation without a murmur, but absolutely without wincing. The
surgeon who performed the operation said afterwards, "It was like
cutting wax and not human flesh, so far as any reaction was concerned,
though of course it bled very freely."
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Professor William James has noted this same power with regard to that
most painful of all diseases in which pain seems so much harder to
stand because it is hopeless, and there is no possibility that the
endurance of it can lead eventually to any improvement. The patient
must just stand being racked to pieces until the end comes. No wonder
then that the professor of psychology should note with commendation
the effect of religion in bringing about a sense of well-being in
spite of the constantly progressive physical condition which was so
painfully eating life away. He said:
"The most genuinely saintly person I have ever known is a friend of
mine now suffering from cancer of the breast--I hope that she may
pardon my citing her here as an example of what ideas can do. Her
ideas have kept her a practically well woman for months after she
should have given up and gone to bed. They have annulled all pain
and weakness and given her a cheerful active life, unusually
beneficent to others to whom she has afforded help. Her doctors,
acquiescing in results they could not understand, have had the good
sense to let her go her own way."
Many physicians, I am sure, have had the opportunity to witness
instances very like that which is thus recorded with whole-hearted
sympathy by Professor James. I count it as one of the precious
privileges of life to have known rather well a distinguished professor
of anatomy at Professor James' own university. He suffered from
incurable cancer and two years before the end knew that nothing could
be done for him and that it was just a question of time and pain and
the most poignant discomfort until the end would come. He continued
his lessons at the university; he finished up a book that he {270} had
long wished to write and had begun several times; he maintained his
simple, social relations with friends in such a gracious spirit that
none of them suspected his condition and continued until the very end
bravely to go on with his work quite as if there were nothing the
matter.
I shall never forget how shocked I was when I once presumed to invite
an addition to his labors by asking him to make a public address, and
he told me, as a brother physician, just how much he had to be in the
trained nurse's hands every day so as to keep himself from being
offensive to others. I had met him at lunch in the bosom of his family
and spent several pleasant hours with him afterward without ever a
thought of the possibility of the hideous malignant neoplasm which was
constantly at work making a wreck of his tissues and which no one knew
better than he would never be appeased with less than his death.
He himself would have said that whatever there was of courage in his
conduct was due to the strength that came to him from prayer. It was
his consolation and the sources of the energy which enabled him to
stand not only the pain he had to suffer but to suppress any
manifestations with regard to it and keep on with his work.
There is an impression in many minds that as time goes on and medicine
and surgery advance and science scores further triumphs, pain and ill
health generally will decrease, and there will not be nearly so much
necessity for standing pain as there is even at the present time.
Besides, it is thought that the discovery of new modes of stilling
pain will still further eliminate the necessity for patience. As a
matter of fact, all our advance in hygiene and sanitation and
scientific medicine has served {271} rather to increase than lessen
the amount of pain. People now live longer than they used to. They
live on to die of the degenerative diseases which are slow running and
often involve a great deal of pain over a prolonged period. One
reason, probably the most important one, for the great increase of the
number of deaths from cancer in recent years is the fact that ever so
many more people now live on to the cancer age than before. Every year
beyond forty which a human being lives increases the liability of
death from cancer in that individual. There are some enthusiasts in
the field of medicine who are inclined to think that we may discover
the cause of cancer and eliminate the disease, but after a generation
of special effort in that direction with absolutely no hopeful
outlook, this is at least a dubious prospect. Indeed, there are many
good authorities on the subject, who are inclined to feel that cancer
more often represents an embryologic or developmental defect than
almost anything else and that in so far as it does we can scarcely
hope ever to eliminate it.
While the death rate from other acute diseases has been decreasing in
recent years and especially from the infectious diseases, the
mortality from affections of the kidneys, heart and brain has been
increasing. Almost needless to say, these affections are practically
always chronic, involve definite discomfort when not positively acute
suffering, and not infrequently produce bodily states in which people
must bear patiently a great deal of discomfort, sometimes for years.
When people live beyond middle life they become more and more liable
to be affected by these diseases, so that instead of needing less
consolation for pain, our generation and the immediately succeeding
generations at least are going to {272} need more. It is particularly
the people who are stricken with chronic disease who need the
consolation afforded by religion, above all when they know that their
affection is essentially incurable and that the only absolute relief
they can have will come from death.
It is with this as with regard to hospitals and charity. The greater
the advance in medicine and the longer people are kept in life, the
more need there will be for hospital care and consequently for the
exercise of charity in the best sense of that word and also for
patience in pain and suffering. In these matters, as with regard to
knowledge, science, instead of lessening the need of religion and its
influence, is multiplying it. There is not the slightest reason for
thinking that a man will ever make here on earth a heaven in which he
may be perfectly happy, and even those enthusiastic advocates of
modern progress who are inclined to think of the possibility of this
set the date of it so far forward in the future, especially since the
disillusionizing process of the Great War, that even the fulfillment
of their prophecy is not likely to do very much good for our
generation or for many subsequent generations. We are going to need
the consolations afforded by religion even more than our forefathers
did in the past, now that physicians are able to prolong life and yet
cannot entirely do away with suffering.
Above all it must not be forgotten that the cult of comfort and
convenience and what may well be called the habit of luxury in the
modern time has greatly increased sensitiveness to pain. There are two
elements that enter into suffering, as we have said in the chapter on
that subject. The one is the irritation of a sensitive nerve and the
other is the reaction to it in the mind of the sufferer. If, for any
reason, the nerve has been rendered {273} insensitive, or the mind put
in a condition where it cannot receive the irritation, the subject
will not feel the pain. If anything has happened to increase the
irritability of a nerve, as happens, for instance, when continued
irritation has brought more blood to the part than usual and the
affected area is hyperemic and swollen, the pain will be greater
because the nerve is more sensitive. If anything happens to make the
mind more receptive of pain, and especially if the pain message that
comes up along a nerve is diffused over a large part of the brain
because there is a concentration of attention on it, then too the pain
will be ever so much worse. We are, in various ways, adding to this
subjective element of pain and therefore increasing it. We are going
to need then all the possible consolation that can be afforded by
religious motives.
In an article written for the _International Clinics_, [Footnote 11]
on "Neurotic Discomfort and the Law of Avalanche", I called attention
to how much even comparatively mild pains can be increased by
concentration of attention.
[Footnote 11: Series 23, Vol. IV.]
The law of avalanche is a term employed by Ramon y Cajal to indicate
the mode by which very simple sensations at the periphery of the body
may be multiplied into an avalanche of sensations within the brain. In
a lecture of his for _International Clinics_ [Footnote 12] Professor
Ramon y Cajal said: "Impressions are made upon single cells at the
periphery. As the result of the disturbance of the single cell, an
ever-increasing number of cells are affected as the nervous impulse
travels toward the nerve-center. Finally the nervous impulses reach
the brain and are spread over a considerable group of pyramidal cells
in the cortex."
[Footnote 12: Series 11, Vol. II.]
In his paragraphs on attention he says that if conscious {274}
attention is paid to the sensation a great many other cells throughout
the brain become affected by it. It may be that every cell which
subtends consciousness will at a given moment of intense attention be
tingling from a single sensation. If it is unpleasant, the
unpleasantness is multiplied to a very serious degree. The "law of
avalanche" has a very large place in disturbing the lives of those
people who have much time on their hands to think about themselves and
who are always solicitous lest some serious condition should be
developing.
Our self-conscious generation, as religious impressions have been
diminished in recent years, is making its pains ever so much more
difficult to bear than they were before. Paying attention to slight
discomfort will quite literally turn it into a veritable torment.
Prayer of itself, by distracting the attention, will act in an actual
physical manner to reduce the pain, and the habit of prayer could
accomplish very much in that direction. The feeling that somehow the
pain that is being borne is not merely a useless torment but has a
dual beneficial effect in strengthening character and storing up merit
for the hereafter, as the religious minded believe, will do a very
great deal to make the pain more bearable. As we are not going to have
less pain for humanity, and suffering and death are to be always with
us, not even the most roseate dreams of medical scientists
contemplating their elimination, it is easy to understand how valuable
religious motives will continue to be. Meantime physicians have
abundance of experience of how much religion can do to make life, even
under the most trying circumstances, not only useful for self and
others, but even satisfying for those who would otherwise find it an
almost intolerable burden.
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Probably the most fruitful source of consolation to be found in life
is contained in the profound conviction that the Lord and Master said
to those who would come after Him that if they would be His disciples
they must take up their cross and follow Him. One of the very great
books of world literature is "The Imitation of Christ", the keynote of
which is contained in its title.
This little book, which has chapters bearing such titles as "That a
Man Must not be over Eager about his Affairs" and "That a Man has
Nothing Good of Himself" and which suggests "That True Comfort must be
Sought in God Alone" and "That All care Should be Cast upon God" and
"That Worldly Honor must be Held in Contempt" and "That All Things,
however Grievous, are to be Borne for the Sake of Eternal Life" and
"That a Man ought to Consider Himself more Worthy of Chastisement than
of Consolation", has been the favorite reading of more of the men and
women whose opinions are worth while in the world's history than
probably any other, with the exception of the Bible itself. It has
been placed next to Homer and Dante and Shakespeare among the books
which scholars would preserve if, by a cataclysm, all the other books
in the world were to be destroyed. When, some years ago, there was a
spirited discussion in the English newspapers and magazines as to the
ten books which should be selected if one were to be on a desert
island for the rest of life with only these ten books for company, the
"Imitation of Christ" almost invariably found its way into the list
and usually among the first five.
If the little book which emphasizes the pain and suffering of life has
come to be looked upon as one of the greatest books of the world, by
the very fact of its {276} profound treatment of this subject in lofty
poetry, then it is easy to understand the place that pain bears in
life. It is at the very heart of it. Nothing so reveals its meaning
and makes it so bearable as religion. Just as it is true with regard
to suffering, as stated in the chapter on that subject, that the five
poets who at long-separated intervals in the world's history dared to
take the mystery of suffering in the world for the subject of their
poems, made by that very fact the greatest dramatic poetry that has
ever been made, so this humble member of the Brethren of the Common
Life, Thomas a Kempis, working just as the Renaissance was beginning,
and writing the spiritual conferences for "those humble-minded patient
teachers and thinkers" as Hamilton Mabie said, "whose devotion and
fire of soul for a century and a half made the choice treasures of
Italian palaces and convents and universities a common possession
along the low-lying shores of the Netherlands", composed what his
contemporaries called "ecclesiastical music", and what all subsequent
generations have agreed in thinking the most wonderful expression of
the significance of life in terms of Christianity that has ever been
written.
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