Summary:

William Morton first introduced ether anesthesia in 1846. This was followed shortly by nitrous oxide and chloroform. Within a few years, surgical anesthesia was being used throughout the United States. However, widespread acceptance did not mean universal usage. Physicians and surgeons debated the risks and benefits of anesthesia. Anesthesia was thought to be dangerous. Some argued that pain was a necessary part of life, that it made people stronger, and/or that it was a punishment from God. Others argued that anesthesia constituted an abuse of medical power.

Surgeons took care to select appropriate patients for anesthesia, while performing surgery without anesthetics on others. Women, people of higher social and economic classes, and people of the white race were thought to be more sensitive to pain than men, the poor, and Negroes and American Indians. Likewise, the young experienced pain more than the elderly. Certain procedures (e.g. major limb amputations and prolonged tissue dissection) were also thought to require more anesthetic than others (e.g. natural childbirth or ENT surgery). These beliefs carried over into practice, as evidenced by records from the Massachusetts General Hospital and other hospitals in the mid-19th century.

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Scarry argues that pain is the most absolute definer of reality. For the person in pain, there is no reality besides pain; if it hurts, it must be real. This characteristic of pain makes it useful politically. In torture, for example, the reality of the one being tortured is reduced to an awareness of pain, while the torturer’s world remains fully present. This is realized most emphatically when torture is described as information-gathering. The torturer insists on questions that for the tortured are no longer of any concern.

War also makes use of pain. In the dispute that leads to war, one country’s beliefs are pitted against another’s. Both sides’ positions are thus called into question; if there is disagreement about the facts, it becomes apparent that the facts are based in opinion, not reality. The injured bodies of war re-connect the victor’s beliefs with the material world. If the injured body is the ultimate in reality, the injured bodies of war can be used to signify the reality of the victor’s position. Simultaneously, the pain of individuals in war is transferred to inanimate objects or large groups. Thus, one speaks of "Division Six" being wounded or weapons being disabled.

This language also uses the absolute reality of the body in pain to secure the truth of a cultural/political position. Scarry discusses the reality-producing quality of pain in Judeo-Christian scriptures, Marx, and humans’ relationships with inanimate objects.

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In 1938 a 13-year old boy lives through a late summer day in a small town in Tidewater, Virginia. As he delivers the day’s newspapers for Quigley, the local drugstore owner, his mother lies at home dying of cancer. She screams in unrelenting pain, but Dr. Beecroft won’t allow her to have a higher dose of morphine--"Jeff, I just don’t think I can give her any more." He does offer to try a bit of cocaine, but she soon sinks into a terminal coma.

Through the boy’s eyes and memory, we learn of the tension between husband and wife (both well educated people) and about their life in his home town among ignorant Rednecks. As German troops are massing along the border of Czechoslovakia, the boy’s mother dies. His father greets the sympathy of the local clergyman and his wife with a violent tirade against God (if he exists).

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Laurence "Tubby" Passmore is a successful scriptwriter for a television sitcom, in his mid-fifties, married and the father of two grown children. He is indecisive and inexplicably depressed, unhappy with himself, his fat body, bald head, wonky knee, and impending impotence. At least, he is confident in his marriage to Sally, an attractive, self-made academic who enjoys sex; on weekly jaunts to London, he maintains a supportive but platonic relationship with the earthy Amy.

Seeking to alleviate his woes, he dabbles in acupuncture and aromatherapy and regularly attends a blind physiotherapist and a woman psychiatrist; the latter counsels him to write a journal. His wife suddenly announces her wish for a divorce and the television network invokes a contractual obligation to make unwelcome demands on his skills. These events shatter his unappreciated but complacent "angst" and deepen his identity crisis.

Laurence scrambles to rediscover himself. He reads the gloomy, Kierkegaard--because he identified with the titles--and he travels to the existentialist's Copenhagen. He pushes the boundaries of his relationship with Amy in a maudlin trip to Tenerife. He befriends a philosophic squatter, called "Grahame" (with an "e" no doubt to distinguish him from Graham Green whose "writing is a form of therapy" is an epigraph to this book). He flies wildly off to Los Angeles hoping to rekindle a one-night stand "manqué." Finally he recalls and tracks the Irish Catholic, Maureen, his first girlfriend from forty years before. Maureen has suffered too--the death of her son and breast cancer; he finds her on the Road to Compostella.

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The narrator recalls a boyhood encounter with Rab, a majestic dog. Rab causes the lad to make friends with his master, James Noble, a simple horse-cart driver. Six years later, James brings his beautiful old wife, Ailie, to the hospital where the narrator is now a medical student. She has breast cancer and the surgeon tells her that it must be operated the following day. James and the dog are allowed to remain nearby.

Ailie endures the operation in brave silence, commanding silent respect from a lively group of students. James nurses her tenderly, but she develops a fever and dies a few days later. Shortly after her burial, he too falls ill and dies. Rab refuses to eat, becomes hostile, and is killed by the new driver.

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Summary:

This short poem, one of a series entitled "A Catch of Shy Fish," describes an old sick man whose life is "closing in" and who feels only pain ("mind is a little isle") until there enters "an impudence of red," flowers that, for him become a "ripe rebuke," a "burgeoning affluence" that "mocks [him] and "mocks the desert of my bed."

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The physician author is puzzled about what he can do to help a young woman who comes to him for treatment of her chronic abdominal pain. She has had every test, seen every specialist, and has no clear diagnosis. Only on the third visit, which she has initiated, does he discover that she was sexually assaulted at age 14. He is the only person she has told.

He immediately feels out of his element, and asks her to see a psychiatrist. She refuses, and insists he handle her care. He sets up open-ended visits to allow her time to talk, and looks for help in the medical literature and from a psychiatrist colleague.

Over time, as they explore her feelings and experiences, his patient gains self esteem and transforms herself into a confident, beautiful woman, planning on travel, school, and career. After her last visit with him, he realizes, "I had been chosen to receive a gift of trust, and of all the gifts I had ever received, none seemed as precious."

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Summary:

In the introduction to Harvesting the Dew, Judy Schaefer poses the question, "Are nurses mere observers?" She goes on to reply, "in my view the nurse has a vantage point of not only observer but inflicter." This book is a collection of 60 poems arranged in three sections ("Day Shift," "Evening Shift," and "Night Shift") that correspond with three different nursing milieus and moods.

The book also includes an explanatory essay, "A Literary Nurse Bearing Witness to Pain," which concludes "literary nurses then are no longer anticipatory handmaidens but are a profession of men and women with their own highly valued language and structure for observation . . . Literary nurses will further define the caring that is crucial to the nursing profession."

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Summary:

Ruthie is a thirty five year old overweight mother of two married to Ruben. Ever since her marriage, she has experienced pain with intercourse. She feels like an odd contradiction, with too much flesh and too narrow a vaginal opening, able to experience childbirth but not intercourse. She has read books about pain with intercourse, has tried lubrication, like her doctor recommended, but still the pain continues. She cannot imagine painless intercourse without completely leaving her body and wonders if she would ever get it back afterward.

She imagines what her life would be like if intercourse didn't hurt, how she would be fearless, attractive, sexual; how her husband would no longer turn away from her with indifference. As long as sex is painful, her life is concrete, full of duty and care. She imagines that without pain she would transcend this drudgery, even transcend her husband, and enter an ethereal world which centers around her.

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Summary:

In the past, the father has tried to help the child cope with earache by showing him how the ear works, providing a visual image of the ear's anatomy from the encyclopedia. It didn't help the pain. Now that the father is chronically ill, his adult son tries to help, but cannot (even with an encyclopedia that purports to contain the entire world) produce a visual image, or metaphor, to explain the illness, or "what brought us here." Instead, he gives his father a Walkman, hoping that the music will "help him pass the hours in dialysis."

The son can see his father's blood, circulating in the dialysis machine (just as the father helped the son visualize what was happening in his sore ear), but the son cannot feel (or see, or hear--or, even though he's a poet, find a metaphor to convey) what it is like to be his father. This isolation is ironically emphasized by the son's gift: because of the Walkman, the father falls asleep "to a music I can't hear / And for which there is no metaphor."

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