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Finding the right words for pain

Yale Medicine Magazine, 2012 - Winter


For a person in great pain, wrote Virginia Woolf, “language at once runs dry.” Woolf’s words resonate for David Biro, M.D., Ph.D., who couldn’t describe his own suffering after a bone marrow transplant. The “privacy” of his pain isolated him from his loved ones, Biro told the audience at a Humanities in Medicine lecture in October.

Biro, a dermatologist at the State University of New York Downstate Medical Center in Brooklyn, came to recognize that metaphors convey the experience of pain on a level that ordinary language cannot. As Biro researched his book Listening to Pain, he found three types of metaphors: first, images (often clichés) that suggest weapons—a shooting pain in the wrist or a knife in the gut; second, images of pain “mirrored” outside one’s self, as by the silent screamer in Edvard Munch’s paintings; and third, images that convey the anatomy of pain, as in painter Frida Kahlo’s 1944 self-portrait, which shows her shattered spine as a broken stone column.

Even a faltering attempt to communicate about pain, Biro said, eases the sufferer’s isolation. “As long as the conversation lasts, we are not alone.”