People in chronic pain have always sought relief-and have always been judged-but who decides whether someone is truly in pain? In this history of American political culture, Keith Wailoo examines how pain and compassionate relief define a line between society's liberal trends and conservative tendencies. Tracing the development of pain theories in politics, medicine, law, and society, and battles over the morality and economics of relief, Wailoo points to a tension at the heart of the conservative-liberal divide. Beginning with the advent of a pain relief economy after World War II in response to concerns about recovering soldiers, Wailoo explores the 1960s rise of an expansive liberal pain standard, along with the emerging conviction that subjective pain was real, disabling, and compensable. These concepts were attacked during the Reagan era of the 1980s, when a conservative political backlash led to decreasing disability aid and the growing role of the courts as arbiters in the politicized struggle to define pain. Wailoo identifies how new fronts in pain politics opened in the 1990s in states like Oregon and Michigan, where advocates for death with dignity insisted that end-of-life pain warranted full relief. In the 2006 arrest of conservative talk show host Rush Limbaugh, Wailoo finds a cautionary tale about deregulation, which spawned an unmanageable market in pain relief products as well as gaps between the overmedicated and the undertreated. Today's debates over who is in pain, who feels another's pain, and what relief is deserved form new chapters in the ongoing story of liberal relief and conservative care.
Keith Wailoo is the Townsend Martin Professor of History and Public Affairs and Vice Dean of the Woodrow Wilson School of Public and International Affairs at Princeton University. He is coauthor of The Troubled Dream of Genetic Medicine: Ethnicity and Innovation in Tay-Sachs, Cystic Fibrosis, and Sickle Cell Disease and author of Drawing Blood: Technology and Disease Identity in Twentieth-Century America.
Introduction. Between Liberal Relief and Conservative Care 1. The Trojan Horse of Pain 2. Opening the Gates of Relief 3. The Conservative Case against Learned Helplessness 4. Divided States of Analgesia 5. OxyContin Unleashed Conclusion. Theaters of Compassion Acknowledgments Notes Index
Physicians and social scientists are aware that individual pain is complex and elusive-an aggregate of physiology, cultural context, and idiosyncrasy. Wailoo has added a significant analytic dimension to this understanding of pain by incorporating the domains of ideology and politics as they are reflected in policy. A highly original and persuasively argued contribution by one of America's most prominent historians of medicine and society, Pain will attract a wide and thoughtful readership. -- Charles E. Rosenberg, Harvard University Wailoo's ambitious volume tells post-World War Two American political history through the story of pain: its cultural meanings, economic costs, and bureaucratic management and its political uses and abuses. No other work I know of sustains such a macro-analysis while attending to pain's medical, moral, and media significances. And reading it hurts not-and for policy makers might even be therapeutic! Bravo! -- Arthur Kleinman, Harvard University At once capacious and focused, Pain expands on the cultural histories of this compelling topic by admirably developing the political construction of the elusive and yet ever-so-material experience of pain. The politics of pain, disability, medicine, and suicide emerge as Wailoo's book ranges across the rhetoric of a 'bleeding heart' liberal to the conservative uses of rugged individualism in relation to the pharmaceutical industry. -- Rosemarie Garland-Thomson, Emory University Beautifully written, broad ranging, deep, wise, unexpected, and endlessly fascinating. -- James A. Morone, author of Hellfire Nation: The Politics of Sin in American History and coauthor of The Heart of Power: Health and Politics in the Oval Office
I wasn't sure what a palliative care doctor was doing reading about the political history of pain, but I soon found it hard to put down... Anyone who works in palliative care and has a broader interest in the political and legal aspects of pain management and physician-assisted suicide will enjoy this book. -- Roger Woodruff International Association for Hospice and Palliative Care This book should be read by patients, clinicians and policy makers who wish to understand the recent past to guide future advocacy, public engagement and policy as we seek... to change the way chronic pain is perceived, managed and judged-for the betterment of all. -- Richard Payne Pains Project A deeply felt and provocative history of the political uses to which pain has been put in modern America. Science Will surely bring to mind the aphorism of Santayana, that those who ignore history are doomed to repeat it. But it does so much more: If we want to understand the origins of terms such as 'welfare queen' and 'entitlements for the undeserving' and 'givers versus takers,' we need look no further than Pain: A Political History. -- Troy Duster Chronicle Review This well-rounded discussion of the politics of pain and pain relief in post WW II America is an approachable resource for readers from many disciplines and backgrounds... This book would be a good political entry point for scholars in sociology and medical humanities, and medical practitioners. Readers in political science and public policy will find this a good topical summary of pain management laws and movements. Choice In short, Wailoo argues, pain is an effective political issue. It just depends on whose pain you're talking about. -- Sam Baker National Journal An interesting and engaging read... It is refreshing to read about the need to find a middle ground when discussing pain in relation to the political forum... This book would be of insight to anyone with an interest in the historical management of pain. The Nursing Times
