NONFICTION - Oct. 27, 1991

THE CULTURE OF PAIN by David B. Morris (University of California: $29.95; 342 pp.) The crux of this thoughtful and original book lies in the distinction between two portraits that are reprinted in its pages. The first--Rene Descartes’ sketch of a nerve running from a man’s foot, which is next to a fire, to his brain--represents our contemporary notion of pain. It omits any details about time or place, suggesting that pain is merely a physiological, “organic” event. The second--a portrait juxtaposing Jesus’ flagellation with two 15th-Century fathers discussing the recent deaths of their sons--offers a more sophisticated interpretation of pain, which the author, a retired English professor, believes was lost with the advent of modern medicine: pain as a social and psychological product, caused as much by poverty, hunger and fear as by neurotransmitters and “action potentials.”

Most general practitioners realize that pain is often psychosomatic, of course, a fact that Morris fails to acknowledge. But Morris’ visits with chronic-pain patients while researching this book indicate that most doctors, rather than acting on this knowledge, continue to prescribe mostly pills and pins. One drill-press operator, for instance, suffering from intense elbow pain, bursts into tears when Morris asks her about her hopes and dreams. Yet when Morris consults her medical record, it reads, he discovers, “exactly like the history of an elbow.”