Keith Wailoo, “Pain: A Political History” (Johns Hopkins UP, 2014)

Is pain real? Is pain relief a right? Who decides? In Pain: A Political History (Johns Hopkins University Press, 2014),Keith Wailoo investigates how people have interpreted and judged the suffering of others in the US from the mid-1940s to the present. While doctors and patients figure in his story, the primary protagonists are politicians, judges, and ideologues, who variously understood the ambiguities of pain as political problems to be settled in legislatures and in courts of law and public opinion alike. For instance, in the 1940s and 1950s, the “pain complaint” of ailing World War II veterans became the locus of debates about manhood, federal disability benefits, and pharmaceutical interventions. Although physicians faced complex problems about adjudicating the pain of their patients, Wailoo shows that pain was also a deeply cultural problem, especially as new, competing theories of pain emerged to explain not only the experience of suffering, but the character, motives, and rights and responsibilities of the sufferer. In the Reagan administration-era, debates about pain were an index of America’s welfare problem, and in late 20thcentury, controversies over fetal pain and the “ultimate relief” of physician-assisted suicide reflected the polarized landscape of “liberal” and “conservative” positions. The last chapter, “OxyContin Unleashed,” compellingly shows how a de-regulated and pro-business pain policy led to the pain drug boom in a competitive and unstable medical marketplace. Ultimately, Wailoo claims that “we have a cultural problem understanding people’s pain.” Pain shows us how that has taken place throughout our recent history, and challenges us to acknowledge and attend to the way that we politicize the pain of others without regard for their suffering.

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