Excerpt of All In My Head by Paula Kamen
(Page 3 of 9)
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And not to toot my own horn, but this display was also quite
adept at illustrating basic neurological concepts in the treatment of pain.
Fundamental was the gate theory, first formulated in 1965, which demonstrates
how counterirritant pain blockers (Ben Gay, electrical stimulators, acupuncture
needles) work, by blocking pain signals from the spinal cord. On the right lower
panel of my poster board display, this process was illustrated by two parallel
spaghetti noodles, representing the C nerve, the source of the pain, and then
the friendlier A delta nerve. At the point where they reached the spinal cord,
the A delta branched downward to overlap the C and impede its signals with a
little "gate." In another diagram, I illustrated another relatively
new scientific concept of that time: endorphins, "pain-fighting chemicals
which are made in the pituitary gland in the brain." I explained that we
try to activate these natural opiates in a variety of ways, such as placebos
(fake pills that the patient thinks are the real thing) or acupuncture.
The result: I got a B on it.
Indeed, in the end, with so many possible interpretations, the
really awful part of having a really bad headache that won't go away is the
confusion of it all. What does it all mean?
How we conceptualize and treat real physical pain is indeed
rooted in our culture, and our culture today gives us more mixed and extreme
messages than ever before. On the one hand, everything I know from growing up in
an educated, doctor-worshiping Jewish home in the Midwest pulls me to the first
answer, that basically "shit happens" in life, and that Western
doctors are the answer. But then, the whirlwind of popular alternative medicine
philosophies of the past several years-not to mention, my own natural internal
quest for meaning-alert me to a second universe of other possibilities.
But I do know for sure that I'm not alone in asking such
difficult questions about the experience of chronic pain in the United States,
in one form or another. In our culture, experiencing chronic pain or any
long-term illness can be a complicated, isolating, self-blaming, guilt-ridden
process. Millions of chronic pain sufferers in the United States like me have
silently suffered their own individual and profoundly strange battles. In the
process, we've questioned and overturned basic concepts of ourselves, of the
medical system, of the world, and of illness and its metaphors. We need to share
our journeys through this strange terrain for the benefit of those just
beginning their struggles. More than a decade ago, when I embarked on my search
for a cure for an American headache, I was painfully ignorant about the real,
often hidden limits of many common treatments, from both Western and alternative
medicine. I wish I had been armed with such essential, hard-won, critical
Needless to say, this book, my second major lifetime report on
chronic pain in the United States, has been much more complicated to research
than the one I did in 1979. When I wasn't a patient with actual pain,
understanding how to control it seemed so much easier, so much more
straightforward. In my sixth-grade report and display, I was just giving the
obvious facts, which had been mapped out for me in the clinical literature and
were translatable to a two-dimensional cardboard display.
In this book, in addition to developing and expanding on some of
that information, I try to fill in some gaps, examining many popular and
culturally rooted myths denying the physical realities of chronic pain. Most
basically, I describe the experience and ask questions from the perspective of
the patient. And as in my other writing as a journalist, I hope to give the
"bigger picture," so that my story doesn't start and end just with me
personally. As well as eventually telling about other patients I have met, I
also report some findings about chronic pain, culled from texts, interviews, and
From the preface to All In My Head, pages ix - xvi.
Copyright Paula Kamen 2005. All rights reserved. No part of this
book maybe reproduced without written permission from the publisher, Da Capo Press.