An analysis of health data reported by Northern Health to the Canadian Institute for Health Information shows that residents in area care facilities are experiencing pain at moderate to excruciating levels at more than twice the national average. The Citizen's Christine Hinzmann reported the numbers as part of a series of stories comparing levels of care in Northern Health to other regions across B.C. and Canada.
The use of restraints is a more objective measurement, a yes/no equation, but pain is more subjective. Reporting pain levels requires an individual reporting that pain is present and a person making an assessment on the intensity of that pain, based on what the individual is expressing. People with cognitive issues that require long-term care may not be able to communicate their pain or the degree of it.
Measuring pain felt by others is further complicated by an individual's relationship with pain.
Psychologists have demonstrated that people imagine pain to be far worse than it is when they haven't actually experienced such an injury, regardless of whether it's a physical or emotional trauma. Furthermore, many people who have experienced horrific injuries, such as the loss of a limb or the death of a child, report years later that their pain was terrible and will never fully subside but was not as devastating as they thought it would be.
This is how people process ongoing pain and free themselves from its debilitating effects, by diminishing its hold on their well-being and by developing a new normal that means judging their lives by where they are now, not where they were the day before their life-changing injury.
The body and brain can be taught to accept astonishing levels of pain. Numerous rite of passage exercises are held in societies around the world that involve overcoming pain. There is an indigenous tribe living by traditional means in the Amazon rain forest that has every young boy at a certain age place their hand in a makeshift glove filled with fire ants. The bites are so painful and the venom the ants secrete into the wound so toxic that the boy hallucinates for hours. This process is repeated multiple times over a period of time.
The result is not only the transition from boyhood to manhood but it also has the practical application of making the man largely immune from the bites of the ant when he joins the other man on hunting expeditions in the forest.
In Western society, we have our own rites of passage involving pain, from giving birth to completing a marathon or a triathlon. The individuals who complete all 24 hours of the annual Relay For Life know it will be painful and difficult but they do it to pay tribute to loved ones taken by cancer and because they know their pain isn't anywhere near the ongoing suffering of people with that dreaded disease.
Pain is one thing, but suffering is much worse. Pain is temporary by its very nature because it's only able to be understood as pain when its absence is also felt. Stubbing a toe on the dresser or burning a hand on a hot stove hurts because there was no such pain present the instant before.
Suffering, however, is ongoing pain, with no promise that the pain will diminish at some future date and/or the pain can ever be effectively controlled or managed by the person experiencing it. If pain wounds the body, suffering scars the soul, inflicting emotional damage that lasts a lifetime. Witnessing suffering is also excruciating, which is why people put down their sick pets and why spending extended amounts of time visiting a hospital is so difficult.
Pain has a practical biological purpose, of course, because its presence signifies a serious threat. Philosophers, particularly those of religious faith, have struggled with the meaning of suffering in a world where the divine creator is merciful, not cruel. C.S. Lewis, best known for the classic children's literature series The Chronicles of Narnia, wrote an entire book - The Problem of Pain - trying to reconcile that very issue. He wasn't the first, of course. The entire Book of Job in the Bible's Old Testament, not to mention Christ's crucifixion, explore the nature of human pain and suffering.
Not even Lewis could create a vocabulary for pain, which is why there aren't a lot of words to describe pain or its degrees. People near the end of life are "made comfortable," through pain management.
In the end, pain, even more so than death, is what gives a mortal life meaning. Our efforts to combat it, mask it, dull it and ultimately escape it, for ourselves and for others, also gives life meaning. We know we'll never be completely successful but our efforts, individually and socially, whether we're doctors or nurses, patients or bringers of comfort, makes us stronger and binds us closer together.
