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John Keltner, pain therapist (cited in Thernstrom 2010: 324) Despite the fact that human beings have lived with pain from time immemorial, there remains a great deal of controversy concerning its nature and its meaning. Before the modern era, pain was understood across many cultures as a sign for something else: punishment, a message from the gods, a measure of payment, etc. In our own time, pain has been variously understood as simply a symptom for some other concomitant condition, a disease in its own right, a neurological subsystem comparable to other sensory systems such as sight or hearing, a psychological rather than a physical state, a physical rather than a psychological state, etc.

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I knelt beside him and found that small stones and twigs had jammed through the end of the bone into the marrow cavity. I had no choice but to amputate the leg below the knee. (1997: 7) Brand’s physical descriptions of situations of pain—like Daudet’s description of an excruciating painful treatment for his condition, physicians hanging him from his jaw to loosen up his spine, the part of his body from which much of his pain originated (2002: 30)—produce a visceral reaction, a kind of harrowing experience we often have when we encounter someone in pain.