One of the most gruesome and intriguing books I’ve ever read was written by a British physician who specialized in treating medical conditions commonly referred to as leprosy. In The Gift of Pain, Dr. Paul Brand tells the poignant story of a young man named Raman, a patient at his clinic in India.
Raman’s leprosy, called Hansen’s disease, rendered him utterly insensitive to physical pain. Desensitized to injury, “lepers” are extra susceptible to wounds, infections and gross disfigurements of the skin and other features. The social stigma and practical difficulties of treating this condition are so formidable that many patients lose hope and stop complying with treatment. These despairing souls are true outcasts, occupying the lowest social stratum of any society they live in.
Raman, as Dr. Brand noted, possessed the courage and diligence to comply with the medical program. As his hands responded to treatment and became more dextrous, he experienced an expanded sense of self, giving him great hope for the future. He was eventually certified negative for leprosy.
Even though he still couldn’t feel pain in his hands, they were functional. If he was careful to maintain his visual self-examination discipline, he would do fine. He went back to his hometown, eager to show the family that had ostracized him that he was all better.
Two days later Raman returned to the clinic completely defeated, with his hands bandaged. Despite his best efforts, both hands had been severely damaged on consecutive nights. One hand was gouged by a rat that had eaten his flesh while he slept, and the other hand had burned when it fell against a hot lamp, also while he slept. In deep despair, Raman, once he could speak about it, exclaimed, “I feel like I’ve lost all my freedom… how can I ever be free without pain?”
The perception of pain, known as nociception, is essential for developing the physical and emotional boundaries that allow all of us to survive in the world. Without it, human beings descend into a nightmare of painless confusion, emotional contraction and isolation.
The experience of pain is both universal and intensely personal. When another person understands our pain we’re soothed because we feel less isolated. When another dismisses our pain as insignificant, we may feel humiliated. Understandably then, we disdain the experience of pain and react cautiously, even cynically, towards its proffered lessons about who we are and what connects us with our fellows.
Strange as it may seem, we need the instructive realities of pain to not only warn us of danger and injury, but to bring definition to our identities: our sense of where we end and the world begins, physically and emotionally. This is how our suffering can be redemptive: being attentive to its lessons brings not only physical welfare but also emotional safety. Making the pain go away without gleaning the fruit of self-knowledge, squanders the opportunity to trade misery for insight and freedom.
When a leprosy patient has no sensation in the limbs, an unfortunate psychological shift may take place. The patient’s sense of his physical self contracts; it no longer includes the parts he cannot feel or use well. When the use of limbs are restored, a delightful emotional expansion takes place. That which the patient regards as his “self” has grown and is more available to him.
Our emotional lives are similarly connected to this dynamic of expansion or contraction. When we recognize and accept the full range of our emotional experience, especially the emotions that are unpleasant or shameful to us, then more of our emotional selves becomes available to us, and our inner lives are pleasingly expanded. When we do things to avoid, repress, or blunt emotions we don’t approve of, we experience a contraction of our inner lives. Fear-driven behavior, depression, anxiety and addiction involve contracted inner states, often leading to greater isolation.
This hints at the curious relationship between human limits and freedom. Within healthy physical and emotional boundaries, a human being grows, thrives and expands, as seen in child rearing. Without healthy boundaries, a human personality becomes distorted, as with a tyrant who has no restraints on his behavior.
A life without pain is a life without limits. A life without limits is unhealthy and undesirable, sad and sometimes monstrous, and always tragic. I’m not arguing that we deliberately seek out pain. Life itself doles out quite enough struggle for all of us to learn essential lessons about ourselves. But what a sweet relief it is to draw a truce with our pain, when we’re ready to do so, and be inquisitive about what it says about our places in the world.
When we discover that pain, though terrible, is also a gift-giver, then all our experience becomes imbued with meaning. This is one of the exquisite consolations of philosophy.