The Body in Pain

2. The Body in Pain

Elaine Scarry writes about and explains the history of culture through the lens of pain and the human attempt to express and modulate bodily pain by creating artifacts such as clothing, furniture, language and God. She outlines the structure of two kinds of human interaction, torture and war, in which pain is a major currency. Her argument is that both torture and war, through their use and objectification of pain, severing it from its experiential origins in a single human consciousness, act to unmake or destroy language and culture. On the other hand, according to Scarry, human imagination is crucial in the process of making or creating artifacts, and serves as a complement to pain. Scarry goes on to outline the stories of the Judeo-Christian bible and Marx’s Das Capital as histories of three kinds of objects, the ‘weapon’, the ‘tool’ and the ‘artifact’. The artifact is created by the imagination of a single human consciousness and enables sentience to be shared, unlike pain which is a fundamentally private and unsharable experience.

Virginia Woolf complained that “English, which can express the thoughts of Hamlet and the tragedy of Lear has no words for the shiver or the headache… The merest schoolgirl when she falls in love has Shakespeare or Keats to speak her mind for her, but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.” According to Scarry, pain not only resists language but destroys it, resulting in a reversion to a stage before language, to the cries and grimaces of an infant.

Pain entails this shattering of language because, in contradistinction with our other internal states of consciousness, it has no object. Scarry observes that we do not simply ‘have feelings’, instead we ‘have feelings for X’ when X is the object of love, or hatred. Similarly, our senses are accompanied by objects – we see Y, hear Z. Even our drives have an object – we are hungry for a particular food, we thirst for water. Physical pain alone has no referential content.

Pain is by its nature divisive, because it signals at once certainty in the person experiencing it subjectively, and at the same time doubt or uncertainty in the objective witness, because there is no way of getting around the fact that the pain is located inside the sufferer’s sentient body and sensorium or subjective soul. The lack of speech, language or verbal expression for pain amplifies this dichotomy.

Nevertheless, pain as a symptom is crucial to medical science, and therefore there have been attempts to objectify it. One example is the Melzack McGill Pain Questionnaire, which allows for the evaluation not only of the severity of the pain, but also its other sensory qualities, such as ‘throbbing’, ‘burning’, ‘sharp’, ‘dull’ etc. Melzack was inspired by his patients’ verbal descriptions of their pain to formulate his neurological ‘Gate Control Theory of Pain’.

Amnesty International relies on descriptions of the pains of torture to try and bring about an end to this cruel and unnecessary practice. The first part of Scarry’s book is an analysis of the pain, structure, and political implications of torture, compiled with the help of research by Amnesty International. The legal system is another arena in which the physical reality of pain must be translated into words in order to achieve justice.

Art is another arena in which pain enters the language of human objectification. Scarry quotes Nietzsche’s description of his pain as a ‘dog’: “It is just as faithful, just as obtrusive and shameless, just as entertaining, just as clever as any other dog – and I can scold it and vent my bad mood on it, as others do with their dogs, servants and wives.” Bergman’s movie Cries and Whispers opens with a woman’s diary entry, “It is Monday morning and I am in pain,” which becomes a repeated theme as hinted at by the title. However, Scarry notes that psychological suffering dwarfs physical pain as far as its representation in art, calling our attention to the question whether expressing pain and eliminating pain are related. It also makes me wonder whether physical pain is somehow taboo as an object for art and conversation, given the plenitude of representations both of physical violence and of emotional pain.

The inexpressibility of physical pain makes it a difficult subject politically, and yet it is of mounting concern in view of the global effort to make civilization more human, by eliminating torture, and (in my view) the increasing objectification of medicine as a science rather than an art. While the latter has its underpinnings in technological progress, the resultant silencing of the patient’s subjective experiences of pain has much in common with the dialog concerning torture and war.

The word pain has its roots in the Latin for punishment, ‘poena’. Scarry notes that perhaps because of the aforementioned difficulty in representing pain itself, it is often represented with the sign of the weapon. We use words such as ‘sharp’, or ‘like a knife’ to describe pain. Conversely, the experience of pain is associated with weapons, as when the 14^th Century mystic Margery Kempe speaks of the ‘boisterous nail’ emulating the cries produced by the person in pain, and Wittgenstein conceives of a stone that causes hurt as having ‘pain patches’ on it. Primitive healing rituals can involve pulling the pain out of the body with a weapon, and the language used to describe the physiological mechanisms of pain includes terms such as ‘trigger points’. Odysseus, initially blind to Philoctetes’ pain, notices it when he is required to attend to his bow. As Michael Waltzer astutely observed, “I cannot conceptualize infinite pain without thinking of whips and scorpions, hot irons and other people.”

Writing that emphasizes the language of agency negates pain, illustrated by the litany of weapons in De Sade’s writings. The language of agency confuses pain and the causing of hurt with power. One can see how the absence of an object makes it tempting to use weapons, which have an object, as a metaphor for pain, but that such an analogy is vastly misleading because the weapon has a wielder as well as a victim.

Scarry proposes that the complement of pain is the imagination, which has objects but no associated ‘objectless’ internal process. In other words, one can think of seeing still going on when there is nothing to look at, but imagination only happens in the act of imagining something. The pain of torture, according to Scarry, deconstructs rather than destroys the prisoner’s voice, shattering their world and making it meaningless. In contrast, the human imagination creates real (and meaningful) objects in the world, whether these are concrete like the products of technology or abstract like God, political and legal systems. This process of construction, by means of created objects of the imagination, is necessary for other persons and their sentience to become visible to us, in order to counteract the depersonalization that happens during torture and war.

2.1. The Structure of Torture

Torture is an act that converts the ‘incontestable reality’ of physical pain into an enactment of power, through the “obsessive, self-conscious display of agency.” Scarry notes how the torturers’ slang frequently refers to the torture chamber as a stage, such as the ‘production room’ in the Philippines, the ‘cinema room’ in South Vietnam, and the ‘blue lit stage’ in Chile. The ‘moral stupidity’ of torture has an unconscious structure whereby the pain is amplified within the person’s body, made visible to those on the outside, and denied as pain only to be read instead as power.

In torture, pain and interrogation always occur together, and Scarry emphasizes that the interrogation is a part of the process and cannot be separated from the pain by claiming it as the motive or justification for the torture, because the torturer’s questions make it clear that they are being asked as if the content of the answer matters when really it does not. The torturer pretends that the answer matters, politically, in order to become blind to the prisoner’s pain. In turn, the prisoner’s world is shattered by world-destroying, intense pain, in order to elicit a ‘betrayal’ in the confession of a family member’s name, a fact, or other information, obliterating meaning in an internal psychic world that has already been rendered meaningless by the pain.

Scarry gives as an example the experiences of Pablo Ibbieta in Sartre’s short story “The Wall”. Ibbieta, threatened with execution by the fascist regime, gives false information about his friend’s hiding place. Ironically, his friend is found at the place he named, and Ibbieta survives. During the night, as he waits to die, Ibbieta vacillates between acute attention to his body’s sensations and a sense of alienation from his body. Ibbieta notes that it is the living tissue of the body, the sentience of pain, that allows it one day to be dead. He experiences the moment in which, as described by George Eliot, the person’s knowledge that “All men must die” is replaced by the intimate awareness that “I must die – and soon.” Ibbieta imagines the body as an “enormous vermin” to which he is tied, for which he has no affection. Nor does the political situation in Spain mean much to him any longer. There is a shrinking of the world around the body, as experienced by very old or sick people, where the sensations of the body breaking down become the all-encompassing objects of attention. Oedipus and Lear, in their dying moments, cling to the world with an outpouring of impressive verbosity, knowing that in silence “the edges of the self become coterminous with the edges of the body it will die with” (Scarry).

As Karl Marx observed, “There is only one antidote to mental suffering, and that is physical pain,” or, on the flipside, Oscar Wilde humorously implored, “God spare me physical pain and I’ll take care of the moral pain myself.” George Eliot’s Arthur Donnithorne introspects morosely that physical pain might lift his obsessive boredom and prevent him from damaging himself, a very young woman, and their societal norms. Emil Zola’s Monsieur Hennebeau wishes that like the coal miners, his “empty belly wre twisted with pains that made his brain reel,” to distract him from his obsessive sorrow over his unfulfilled marriage. Scarry suggests that this power of physical pain to eliminate emotional suffering, by obliterating all psychological content, is what gives it value as a religious experience. Many primitive religious forms of worship climax in pain ceremonies, and the crucifixion of Christ is at the center of Christianity, which historically encompassed self-flagellation and still incorporates forms of asceticism. Surgery, often viewed as a climactic achievement of modern medicine, has historically often achieved healing from pain without what would now be considered a proper scientific explanation (see Chapter 1). Bronte’s Wuthering Heights centers on Lockwood’s dream that the pilgrim’s staff is also a cudgel, and Huysman’s dandy recognizes his susceptibility to religious conversion in moments of great physical pain.

The experience of the prisoner who is tortured is very different from that of pain in a religious context, because the prisoner does not choose this experience. Instead, the prisoner’s pain diminishes his world, and enlarges the world of the torturer. The sentience of the prisoner, and his susceptibility to pain, is what gives the torturer power. According to Scarry, one can rephrase the statement “the torturer inflicts pain in order to produce a confession” with the statement “the torturer uses the prisoner’s sentience to obliterate the objects of the prisoner’s sentience” or, in plainer words, “the torturer uses the prisoner’s aliveness to crush the things that he lives for.” The confession is one of several manifestations of the prisoner’s absent world.

Words for the houses of torture illustrate the metaphor of the room as a hospitable anchor of civilization, such as “guest rooms” in Greece and “safe houses” in the Philippines. A room is also a metaphor of the human body, or of the hug. In torture, the room, like the body is inverted, turned inside out. The room itself like its furnishings becomes a torture weapon. In Greece, prisoners were taken to the window and threatened that they would be “de-fenestrated”, or the door left open so they could overhear threatening conversations about their families. The prisoner’s physical world is constricted to the room and its contents, which all become manifestations of the prisoner’s absent world.

Scarry quotes a detailed account of torture with water that exemplifies the subjugation of the ordinary meanings of the objects of civilization such as pipes and tubs to their Machiavellian enlistment as instruments of bodily agony. The nomenclature used for such apparatus is typically technological, such as “the telephone” in Brazil, “the plane ride” in Vietnam, or “the Motorola” in Greece. Alternatively, it refers to ceremonies such as “the dance” in Argentina, “the birthday party” in the Philippines, and “hors d’oeuvres” or “tea party” in Greece. A third source of names, less frequently used than the first two, is nature tamed, such as “tiger cages” in Vietnam, “the little hare” in Greece, “the parrot’s perch” in Brazil and Uruguay, and “the dragon’s chair” in Brazil.

The context of torture, and the torture room, unmakes two benevolent institutions of society, the trial (representing the state) and the practice of medicine (representing the body). The trial examines evidence that may lead to punishment. In torture punishment is used that may lead to evidence. South Vietnamese torturers openly announce, “If they are not guilty, beat them until they are,” and “If you are not a Vietcong, we will beat you until you admit you are; and if you admit you are, we will beat you until you no longer dare to be one.” Reports of torture from the Philippines include references to “unwanted dental treatment”. Doctors in Portugal studied maimed prisoners in order to better design the torture weapons. Forms of torture in Brazil were called “the mad dentist” and “the operating table.” Syrian prisoners in Israel claim their limbs were unnecessarily amputated, wounds cleaned with petrol, and excessive amounts of blood drawn. In Nazi Germany, the “body” was subverted through the scientific laboratory, torturing prisoners of the concentration camps under the pretense of research rather than as an inversion of medical treatment, and the “state” was subverted through the process of production, in factories, rather than as the inversion of a trial.

Scarry underlines this process of inversion by noting the similarity between words meaning healing and hope, as in ‘host’, ‘hostel’, and ‘hospital’, derived from the root word ‘hos’ meaning house, and their proximity to words such as ‘hostage’ and ‘hostility’. Kafka’s story “In the Penal Colony” illustrates this subversion of civilization’s artifacts to the end of torture and world unmaking in his description of the lethal apparatus as a giant sewing machine. Poe’s “The Pit and the Pendulum” aptly closes with the walls, vestiges of civilization and hospitality, collapsing on the human center and crushing it alive.

The enactment of power in torture emerges from the opposition of body and voice. Both the torturer and the prisoner experience their body and voice as opposites, and their experiences are an inversion of each other. The prisoner loses himself and his voice in the engulfing bodily pain, whereas the torturer amplifies himself and his political world in the question. The question part of the interrogation is an act of wounding, with the words as weapons, and the answer is a scream, a letting go of the capacity to express oneself in words. These metaphorical relations are embedded in the language of the torturers, dramatizing the connection between open wounds and confession: “Here, you’re going to tell all. You will open out like a rose.” Or “You’ll vomit blood and tell us yourself.” (Both witnessed by prisoners under the Colonels’ Regime in Greece).

The body itself is used as an instrument of torture, and its pain is experienced by the prisoner as a form of self-betrayal. In Vietnam, prisoners were forced into a cramped position for months or years, in Spain they were forced to walk on bended knees, in the Philippines to carry a heavy stone while being beaten, in Argentina to stand upright for eleven hours each day, and in Greece, in a torture called “making knots,” to throw the head back and swallow their own saliva repeatedly. These distortions of the human body itself can cause as much pain as any other weapon. In The First Circle, Solzhenitsyn describes how prisoners were forced to keep their hands outside the blanket in the searing cold as they slept at night. “It was a diabolical rule. It is a natural, deep-rooted, unnoticed human habit to hide one’s hands while asleep, to hold them against one’s body.” The body’s small gestures of friendship towards itself have been made by the torturer into the enemy.

Torture emphasizes the ever present distinction between the “body” and the “self” which is otherwise latent except in the extremity of sickness or death. The prisoner’s attempt to let out the pain in screams or cries is subverted by the torturers goal of ‘getting it out’ of him. The words of the confession are tape-recorded and taken away, to become the property of the political regime. Even screams are sometimes recorded, to be played to other prisoners later as part of their torture, rendering them in a state of confusion over who was emitting the cries – themselves, somebody else being tortured concurrently, their family member, or an actor.

Scarry recounts how the smallest communication from a fellow sufferer can be intensely meaningful, and almost dispel the pain under such circumstances, as when imprisoned Chilean women sang on Christmas Eve with all their might, so that their husbands in a nearby camp would hear them, and took comfort from their faint answering song. Torture closes the world of the prisoner and displaces conversation with interrogation, so any opening to such sympathy “counteracts the force with which a person in great pain or sickness can be swallowed alive by the body.”

“To acknowledge the radical subjectivity of pain is to acknowledge the simple and absolute incompatibility of pain and the world. The survival of each depends on its separation from the other.” Scarry uses this observation to pump hope into Amnesty International’s efforts at articulating and publicizing the stories of prisoners, in an attempt to end torture. However, I see a parallel between the process of interrogation in torture and how a medical examination might feel to a patient suffering from chronic pain. Often, after many failed attempts at medical treatment and objective diagnostic measures such as X-rays and scans, the patient is implicitly or explicitly blamed for their own pain and the doctor pulls to extract a confession of improvement, malingering, or psychological pain. Just like torture, the physical pain of the body is transformed into voice. There is no infliction of pain by the doctor, in fact the opposite. But the ‘radical subjectivity’ of pain is denied by the doctor in this interaction. Scarry wonders whether this structure of torture is premeditated, and concludes that it is largely unconscious, deriving perhaps from the nature of pain, the nature of power, and the interaction between their two sources – the body as the locus of pain, and the voice as the locus of power. She goes on to outline the three sequential steps of torture, some of which have parallels in the doctor-patient interaction.

The first step is the infliction of pain. This step is present in torture, but normally absent (or largely absent) from the doctor-patient interaction. The second step is the objectification of the subjective attributes of pain. Scarry lists eight attributes of pain, perhaps the core of her work insofar as it relates to my literature review project here. These attributes “belong equally to the felt experience of patient and prisoner, although it is only in the second context… that they become graspable from the outside.” The third and final step is “the translation of the objectified attributes of pain into the insignia of power”.

The first aspect of pain is its aversiveness. Pain cannot be experienced without wanting it to stop. The negative feelings of the person toward the pain are part of any philosophical discussion or physiological definition of pain itself. “The very content of pain is itself negation.” The second and third aspects are the dissonance of experiences in regard to agency over the pain. When a knife or a pin enters the body, the sufferer may experience internal agency, locating the pain in his or her own flesh. Conversely, pain without an external source is often described in terms of the absent weapon, as in ‘knifelike’, ‘stabbing’, ‘boring’, or ‘searing’ pains, externalizing the agency for the pain. The impact of the pain of torture on human consciousness is symbolized by the conversion of the cultural setting into a torture instrument.

The fourth aspect of physical pain is the conflation of the private and the public, expressed by Francis Bacon’s painting of a figure exposed not only because he is placed on a dais and framed by an arbitrary box in his nudity but also because “his melting body is turned inside out, revealing the most sacred and secret parts of him… During torture, the prisoner is forced to attend to the most intimate and interior facts of his body (pain, hunger, nausea, sexuality, excretion) at a time when there is no benign privacy…” Note that this experience is perhaps not very different from that of a hospital patient, except in the latter case for the hopefully benign and caring presence of nurses.

The fifth dimension is the ability of physical pain to destroy language and verbal objectification, the exact vehicle by which, according to Scarry, the pain could potentially be put out into the world and eliminated. Torturers often strive to eliminate the voice of their prisoners, through murder, mutilation, or by forcing the prisoner to cry only at their whim. The prisoner’s “betrayal” in a political context has its equivalent, in a non-political context, in the patient’s “complaints”, which are equally derided or discredited. Scarry quotes headlines from US newspapers in the 1970’s, when the problem of physical pain was first brought into the public eye, saying “A pain is a pain if you complain” and “Chronic pain can make you one.”

Pain obliterates the contents of consciousness, not only annihilating conscious thought and emotion but also other modes of sensory perception, as in “blinding pain”. This is Scarry’s sixth aspect of pain. The seventh is the totality of pain, which begins by feeling like “not oneself” and ends in the elimination of everything that is “not itself.” The world shrinks when one is in pain. Melzack writes that pain involves multiple areas of the brain, and is not isolated in a single ‘pain center’. S. W. Mitchell, a Civil War surgeon, probably describing what we would now call causalgia, wrote:

“Perhaps few persons who are not physicians can realize the influence which long-continued and unendurable pain may have upon both body and mind. The older books are full of cases in which, after lancet wounds, the most terrible pain and local spasms resulted. When these had lasted for days or weeks, the whole surface became hyperaesthetic, and the senses grew to be only avenues for fresh and increasing tortures, until every vibration, every change of light, and even… the effort to read brought on new agony.”

The eighth element of pain is its resistance to objectification. Although pain is supremely real to the sufferer, unless accompanied by bodily damage or a disease label it is unreal to other people. The lack of acknowledgement or recognition which, if present, could mitigate the pain, magnifies the pain itself, especially in torture where the prisoner’s pain is not only unacknowledged by another sentient human being but actually inflicted repeatedly by the torturer.

This denial of pain is the third step in the sequence on which torture is built. The symbol of the weapon illustrates how the prisoner’s pain is converted into the regime’s power. The torturer experiences the unfolding events exclusively from the non-vulnerable end of the weapon. The false motive of information helps the torturer remain focused if his attention begins to slip toward sympathy for the prisoner. False motives are common in other acts of political violence, such as overzealous arrests and punishment. Camus, in his essay on the guillotine in France, points out that the purpose of executions never publicly declared cannot be deterrence. Arendt, analyzing Hitler’s Germany, emphasizes that the war permitted but could never have caused the mass executions under his regime. Arendt quotes Himmler, saying “‘The order to solve the Jewish question, this was the most frightening order an organization could ever receive,’…So that instead of saying: What horrible things I did to people!, the murderers would be able to say: What horrible things I had to watch in the pursuance of my duties, how heavily the task weighed upon my shoulders!” Bruno Bettelheim wondered why concentration camp guards announced repeatedly to the prisoners “I’d shoot you with this gun but you’re not worth the three pfennig of the bullet,” a statement meaningless to him, until he understood that it was part of the SS training for the sake of the guards themselves. “If the guard’s awareness begins to follow the path of the bullet, that path itself can be bent so that he himself rather than the prisoner is the bullet’s destination: his movement toward a recognition of the internal experience of an exploding head and loss of life is interrupted and redirected toward a recognition of his loss of three pfennig.” (Scarry). While our goal in healthcare is very different from that of the concentration camp guards, we need to guard against this kind of denial in our practice which is too easily resorted to when our efforts to heal the patient fail. This is particularly true in the present era of managed care, when it can feel as though we need to justify every penny to the insurance company. Maimonides had cause for reciting his prayer, “May I never see in the patient anything but a fellow creature in pain.”

2.2. The Structure of War

Scarry goes on to discuss the structure of war. Of all her topics, this one seems the least relevant to our understanding of pain. And yet, many people see their relationship with pain and illness as that of a battle or a fight, and in the common idiom ‘painkillers’ are among the most popular drugs. So in this context, as well as observing the explicit treatment of pain, it might be interesting to consider her analysis of war.

Scarry identifies the main purpose of war as injuring. This is hard to contest, because injuring is so evidently the main outcome of war. Additionally, she points out that war is a contest. She goes on to analyze why, if war is a contest, it could not occur in some less harmful arena than injuring, for instance by means of a giant chess tournament or sports game. The problem would be that the loser would never capitulate. Clausewitz claims that “War is the continuation of politics by other means,” a statement Scarry hotly contests by analogizing it to “Dying is living only different; Bleeding is breathing only not exactly.” Clausewitz tries to show that injuring works by rendering the loser powerless, that a “decisive victory on the battlefield” would “carry the power of its own enforcement”, outshining Freud’s metaphor for war as one-on-one combat whose goal is killing rather than surrender. However, even Clausewitz’s formulation, by his own admission, fails to be confirmed by the evidence of many (if not most) wars, in which either one side was far stronger than the other, or one side backed down before a decisive victory had been accomplished.

Scarry concludes that the decisive quality of injuring, which renders it more suited to political contest than other games, comes from its symbolic meaning. She points out that the end of the war is demarcated by a truce or a peace treaty, which in primitive times might have been signed as an oath using the blood of an animal. Injuring is used to guarantee the truth of the bond by symbolically exposing the inside of the body. It makes real the political fictions of a regime which could otherwise be thrown into doubt by their encounter with the fictions of a different regime. This separable function of injuring is illustrated by the demarcation between Nazi Germany injuring on the battlefields, as part of the contest, and in the concentration camps, an act of injuring that had purely symbolic meaning in propping up the fictions of the Nazi regime. Injuring can be used to substantiate fictions, without regard to the benignity of those fictions, as for example in the Inquisition injuring to prop up the rather harmless myth of Christ, as compared with the Nazis propping up the myth of Aryan supremacy. In most wars, she contends, the functions of injuring as an arena for contest and as a symbolic sacrifice to make real the fictions of a political regime are inseparable from each other. She notes the difference between torture, in which the torturer’s fiction is made ‘as if’ it were reality through the prisoner’s pain, and war, in which the winner’s fiction actually becomes reality, as when for example the surviving citizens of the South themselves became proud citizens of the Union and believers in the abolition of slavery after the end of the American Civil War.

Scarry was writing at a time when the threat of nuclear war was immanent, and she considers this separately from conventional warfare. She notes that in a conventional war, just as each soldier has a choice on every day of action whether to stand by his commitment and fight or to defect, so each country has a choice whether to hold onto its political fictions as true and deny the ongoing injuring, or accept the reality of the injuring and succumb to another country’s political fictions. In nuclear warfare, which makes the contest of injuring vast and almost instantaneous, there is no time either for the citizens to consent or to evaluate the injuring versus the political beliefs on a gradual, ongoing basis. Scarry likens nuclear warfare, as it might be seen in the eyes of future generations if it happened, to our puzzlement over the pyramids. Why did slaves consent to give their pain and physical labor to the construction of another culture’s monuments, instead of giving their lives toward rebellion? For that matter, why did the prisoners of the concentration camps contribute their forced labor to the Nazi regime? I see these issues differently. I think that most people are very attached to their own survival, or the survival of their bodies, and will do almost anything to survive, explaining the pyramids etc. Because of this strong commitment to the survival of bodies, the threat of nuclear war was never materialized, and in fact may have prevented a conventional war between countries governed by Soviet and capitalist political fictions.

How does this analysis of war impact the metaphors of the ‘fight against pain’ or the ‘battle with cancer’ occurring within an individual person? Scarry neatly disproves Freud’s fiction of war between nations as a one-on-one fight on a larger scale, because war (especially in the modern world) so rarely results in outright killing that this can hardly have been its original goal. There are some parallels here, because pain can never be totally defeated – it has to be accepted as part of life and made peace with. Similarly, we talk of a cancer as being ‘in remission’. Nevertheless, these outcomes are sufficient to affirm the person’s fiction of health, of being healthy or having a healthy body rather than being sick or ill. Additionally, we are encouraged by the fictions of medical science to envisage our bodies as a battlefield between defending white blood cells, protective growth and repair mechanisms, mechanisms of feedback, regulation and homeostasis, and the invasion of alien infectious agents or antigens, ‘bad’ cancer cells, stress or the stress reaction, and fictions of pain that our bodies make up.

Sometimes the solution can be quite drastic, with high risks for both body and invading illness. The parallels are obvious between nuclear warfare and radiation treatment or chemotherapy, or radical transplants that carry a high risk of killing the patient as well as the disease. These treatments are often geared to kill off the patient’s own defenses to allow new tissue to grow, or to encourage the acceptance of an outside graft.

Scarry’s analysis of war makes evident the dual role of injuring, both as a contest and as a ritual essential to the contract that brings the war to a close. Similarly, surgery, while it evidently helps in the contest against disease by taking out (literally) diseased organs and tissues from the body, or ones that cause pain, might have a similar dual role. The opening (and injuring) of the body in surgery can serve as a contract for the person, both consciously and unconsciously, in bringing an end to the battle with the illness or pain. This might explain both the powerful placebo effect of surgery, evidenced by widespread elective surgery in this country, and the way that surgery can sometimes have a profound transformational effect on the person’s life by affirming their core inner beliefs about the self, and its fundamental value and goodness, just as the political fictions of a nation are affirmed when it wins a war.

2.3. Pain and Imagining

Scarry asks the reader to imagine (or believe) that imagining is the opposite of pain. She points out, as mentioned earlier, that pain is the only sensation, desire, or state of consciousness that has no object. Conversely, imagining is the only sensation, desire or state of consciousness that cannot exist without an object. She highlights the value of the imagination which, in philosophical discussions, is often thought of in regard to ‘frivolous’ mythical beasts like Pegasus or the unicorn, but it also gives rise to Sartre’s imagined characters of Pierre and Annie, his friends, keeping them alive in his mind while they are gone, and to the creation of invented objects like the train, telephone, and airplane, which all existed in the imagination before they were made into a physical reality. Pain is, according to Scarry, an ‘intentional state’ although it is suffered rather than willed, with no ‘intentional object’, whereas imagination is an ‘intentional object’ - an object of the will, with no experienceable intentional state. Thus, pain and imagination are the ‘framing events’ between which lie all other perceptual, somatic, emotional and mental states that can occur in the human psyche. She points out that vision, touch and hearing, can be perceived to occur in the outside world of their objects, or by bringing that outside world into the human mind, somewhere between these absolutes of pain and imagination. Imagination creates objects when they are not available in the world, as when a lonely person imagines a companion, or perhaps even in dreams, when the world is closed out to let the body rest, and the mind creates images, Scarry suggests, preserving this capacity for self-objectification during these “sleep-filled hours of sweet and dangerous bodily absorption.”

Scarry claims as evidence for her hypothesis that pain and the imagination are each other’s missing counterparts the fact that the word ‘work’ is at once a near synonym for ‘pain’ and for a created object (in English as in many other languages, including Hebrew and Greek which form the bedrock of our civilization). Slavery and poor working conditions highlight the proximity of work to pain, whereas expressions such as ‘work of art’ and one’s ‘life’s work’ stress the importance of the imagination. Insofar as work consists of an embodied physical act (and even non-physical labor engages the whole psyche) it resembles pain, and is perhaps almost as aversive as pain. Insofar as it involves the construction of artifacts, it engages the imagination.

Scarry distinguishes between a weapon and a tool, a distinction I found hard to agree with initially because it seemed so clear to me that ‘weapon’ is a subclass of the class of ‘tool’ that an outright categorical distinction was not only artificial but wrong, because it implies they are at the same level of classification. In Hebrew, ‘weapon’ is a subcategory of a word that means ‘vessel’ or ‘tool’. The word for weapon literally means ‘war tool’ or ‘vessel of destruction’. Another word means ‘tool of [arms]’, where the body part used to designate weaponry is the male member rather than the arms. Categorically distinguishing between a weapon and a tool is difficult, because a knife can be used to kill someone, to butter or cut bread and, in between, to slaughter an animal for food. The hand or fist itself can be used to deliver a painful punch, or to punch in bread. Where Scarry draws the line is that a weapon is used on a sentient surface, whereas a tool is used on a non-sentient surface. Does the surgeon’s knife become a weapon when it accidentally kills the patient? While she acknowledges the problematicity of such boundary conditions, this distinction between a weapon and a tool is seminal to Scarry’s entire thesis.

She describes both the weapon and tool as having in common that they have two ends, and act as a lever, to amplify the action of the person wielding the instrument on the object or sentient being that is being acted on. She points out that the small movement of a finger on the trigger of a gun can shatter a whole body on its other end. Large changes are experienced in the world by means of small experienced changes to the self, when using either a weapon or a tool. The act of the weapon or tool endures in the world, in the form of a wound or, for example, cut grain, for a long period of time without needing to repeat the action. The tool can be considered to have a delayed action on a sentient being, as when the grain is then ground, made into bread and eaten or, more directly, when the tool is used directly to make an artifact such as a chair that can be sat on, to carve a statue or write a story, an action that only completes is ultimate goal when the bread is eaten, the statue seen, or the story read. It is this ‘creative arc’ that ultimately distinguishes between a tool and a weapon, according to Scarry’s terminology.

In the next section of the book, she goes on to discuss some important created objects of our civilization: God and the economic and ideological structures of society. The God of the Jewish bible is interesting, because it is as close as human culture gets to pure imagining, God being explicitly denied the form of an image, although later Jewish and Christian thought relaxes that requirement. Scarry discusses the economic and ideological structures through the writings of Marx, interesting to reexamine in these times of economic collapse after the death of communism. God she discusses through her own reading of the Judeo-Christian scriptures, in which pain abounds.

2.4. The Structure of Belief and its Modulation into Material Making

Scarry understands the Judaic scriptures as a narrative whose main purpose is to separate the human body, and the disembodied voice of God. She observes the structure of the text as an alternation between stories and lists, for example the lists of ancestry such as so-and-so begat so-and-so begat so-and-so, etc., in the Pentateuch and beyond. As an aside, Scarry’s writing itself follows a similar structure, showing a fondness for retold narrative alternating with lists of attributes of the phenomena she wishes to describe, such as the eight attributes of physical pain, which make her book at once both powerfully persuasive, as an iterative and reiterative self-assertion, and difficult to summarize in the form of a linear argument.

The voice of God has two main capacities, or ways of asserting itself in the world. The first way is by anticipating human creation and particularly bodily procreation, in the form of commands such as ‘be fruitful and multiply’, and promises such as ‘I will make you a multitudinous and powerful nation’, which are then confirmed in the recitation of the ancestry lists. God’s power is asserted by the spread of His representation inside the imaginations of the multitudes who believe in Him. The second way is by wounding, injuring, or killing human bodies, ostensibly as punishment for disobedience but more significantly as the consequence of and remedy for doubt, thereby extending God’s symbolic power in the world by contracting the number and longevity of those who do not believe in him. These two capacities of God are movingly brought together in the story of Abraham’s sacrifice of Isaac which, although it occurs only in the imagination because in reality Isaac is substituted by a deer, nevertheless asserts God’s power over both the creative potential and the destructive potential of humanity.

Scarry’s reading of the Judaic scriptures is at its core a Christian one and I would like to add a couple of points here. In English the words ‘worship’ and ‘work’ sound etymologically related, but in Hebrew the two are literally one. Harking back to Scarry’s discussion of work as bringing together the experiences of pain and imagination, this is particularly striking when the ‘work’ is submission to an object of the imagination, whether God or the other gods and idols whose ‘work’ is explicitly forbidden in the ten commandments, and repeatedly punished by God throughout the Jewish bible. The second point I would like to make is that the sacrifice of Isaac has a dual significance to the Jewish people, because not only is Isaac replaced by a deer (a proud moment of moral maturity, sacrificing an animal instead of a human, anticipating the commandment ‘do not kill’) but Isaac (and Abraham) both submit to (and self-inflict) the circumcision, which is a lasting symbol of the wound, the ‘knife in the heart’ of Jewish thought, that links human bodily pain with procreation, because it is the sign of the circumcision which binds Abraham to his promised destiny as the father of a nation, through the mediation of a God who, as Scarry goes on to discuss, is a voice that is at once both formless and at the same time adamantly positioned on the other side of a weapon in its relation to humanity. As an aside, circumcision is thought to have originated in the practice of ancient herdsmen to circumcise cattle since it led to better sexual performance and reproductive success in certain breeds where the foreskin was actually an impediment to their fertility. The relevance of this note here is to highlight the cleverness of the creative imagination attributed to God, transforming His second capacity as a wounding weapon to eradicate doubt, directly into His first capacity as the instigator of pro-creation, by leaving the permanent mark of His weapon on the human reproductive organ.

God’s capacity to instigate procreation begins with His punishing Eve with the pains of childbirth, while at the same time retaining control over the birth of her offspring, a power recapitulated when He enables Sarah and other barren women throughout the Judaic scriptures to become pregnant, without claiming any material involvement in the process of reproduction. God carries the creative potential to make a human womb fertile, or to bring water to a dry well dug by human work. In turn, he commands the men he chooses to wander from one place to another, filling their imaginations not with their own imagined plans but instead with His commandments. In return, wherever they camp, they build an altar which is an inversion of the human body, at once symbolic of both the abandoned tradition of making idols and the abandoned tradition of human sacrifice, replacing them with the new tradition of filling the empty interior of the human imagination with the purely abstract presence of God.

At times when this wandering ceases, the risk that God will be forgotten increases, because the need to find water or fill the imagination with plans of where to go and what to do next are less preeminent. It is at these times that He manifests through the symbol of the wounding weapon. In the Pentateuch this occurs in the story of Moses, instantiated by the voice behind the burning bush, the ten plagues of Egypt, and the horrific killings, plagues and disasters that attended the Golden Calf and other moments of doubt. It is in my view the main theme of the Prophets, exposed in passages such as:

“Their flesh shall rot while they are still on their feet, their eyes shall rot in their sockets, and their tongues shall rot in their mouths. And on that day a great panic from the Lord shall fall on them, so that each will lay hold on the hand of his fellow, and the hand of one will be raised against the hand of the other; even Judah will fight against Jerusalem.” (Zechariah 14: 12-14)

“Behold the name of the Lord comes from far,

burning with his anger, and in thick rising smoke;

his lips are full of indignation,

and his tongue is like a devouring fire;

his breath is like an overflowing stream

that reaches up to the neck;

to sift the nations with the sieve of destruction,

and to place on the jaws of the peoples

a bridle that leads astray.” (Isaiah 30: 27,28)

Scarry cites the way in which the voice is relegated to God alone, in stories such as his anger at the complaints of the people in the desert, and the body is relegated to human beings, who are repeatedly punished and made to suffer pain for attempting to give God a body. God preserves the power of sentience, with none of its accompanying shortcomings, such as physical vulnerability to either spatial impacts or temporal decrepitude, or susceptibility to physical pain. She emphasizes that the banishment from the Garden is presented not as punishment for eating the fruit of the tree of knowledge, so much as prevention from then also eating from the tree of life, which is guarded by “a flaming sword which turned every way.” (Genesis 3: 24). “Absolute verbal purity is eternal life: the projected voice is the power of sentience separated from the fragility and vulnerability that attend sentience at its unprojected site and source.” (Scarry). Moreover, from the Jewish perspective, the words of the bible are literally the only direct, lasting product or manifestation of God and it is in relation to these words (and the masses of commentary that has accrued around them over the centuries) that our path in the world as a body of people, the Jewish People, is defined.

Scarry posits that the major innovation of Christianity has been to replace the sign of the weapon with the sign of Christ, and the cross. The cross is a weapon that unlike a knife, a fist, a gun, or in fact most weapons, has no clear shape or position for the person wielding the weapon, and although presumably there was an executioner his role is by this sign easily overlooked. As evidence for this idea that Christ replaces the weapon, Scarry sites the ease with which the image of Christ is replaced by the sign of the cross. Instead of asserting his power by wounding with a weapon, God is made substantial and tangible in the body of Christ, excruciatingly sentient in His suffering of physical pain. The voice heard by the exclusive few in the Judaic scriptures is replaced in the Christian ones by the universal ability to visually witness Christ, to touch Him, even to feel his wounds (as in the story of Doubting Thomas) and to incorporate his body into one’s own literally by eating it, as emblemized by the Last Supper and in the ritual of Communion.

As compared with the God of the Old Testament, who ‘has no like’, Christ offers “predicative generosity” – I am the resurrection, I am the way, I am the light of the world, I am the door of the sheep, I am the good shepherd, I am the bread of life. He is also eminently describable, His life is told in four versions in the Gospels. The sign of God’s power, where in the Old Testament it was wounding, is in the New Testament healing. Jesus restores sight to blind eyes, heals lepers, and feeds the hungry. In fact, he even does so on the Sabbath, in contradistinction to the one lasting structure the Jewish God imposed on the world of men, the commandment to rest and not work (or do no other work but worshipping God) on the seventh day, a totally arbitrary division of time.

Scarry quotes instances in which Jesus was mistaken for a laborer, a fisherman, or a carpenter, as well as the prevalence of those roles among his disciples, as evidence of the new respect for making as an occupation or way of life. By contrast, in the Jewish tradition, making is viewed distinctly with suspicion because of its proximity to icon-making. Instead, studying the law (in the scriptures and other written and oral traditions, which are held to be God made word) and living it are the valued ways to be in the world. Making is strictly regulated, as in the elaborate, detailed description of the tabernacle and the ark, anticipated by the instructions for Noah’s ark, and the detailed law regarding laying the fields to rest every seventh year, allocating a tenth of the produce to the poor and a tenth to the priests, sharing expensively reared domestic animals with the priests who have no land and make no material goods, but take first pickings of the meat when they offer it to God as a sacrifice, and so on. Disdain is shown for material goods both in the form of the Golden Calf and the trinkets and adornments that went into its making. The holiest thing in the tabernacle is not its rich ornaments but instead what lies behind the curtain, which only select priests of Aaron’s descent can touch without being burnt alive by God.

The new respect for the material, and for human making or creation, is according to Scarry and others the foundation of the materialist culture that later developed in Christian nations. The drive away from the hierarchical authoritarian structures of iconoclasm was furthered in every new splinter within the Christian tradition, from Catholicism to Lutheran Protestantism, and culminating perhaps in the Quakers who gave rise to the vision on which material culture rests in the United States.

It is easy to see how this emphasis on making, even making oneself, and ‘making it’ in the world brought forth new attitudes toward pain. Scarry goes on to talk later about the transition from weapon to tool, with its created object as the thing that acts upon sentience. Meanwhile, I would like to add that the different attitudes toward the self in relation to God and the world carry with them differing experiences of pain and its expression. In the Jewish world, pain is the ‘knife in the heart’ that we all carry as a sign. It is at once commonplace and incomprehensible. Complaining to God only makes Him angry, so we have to listen to each other. No wonder Maimonides and later Freud, stemming from this tradition, extolled the virtues of tears and other expressions of pain, and the value of listening. Meanwhile, in the Christian tradition, God heals. Only direct supplication to God guarantees a cure, and any residual suffering is a sign of impure faith or lack of grace. Whereas for Jews, the path to the tree of life is blocked, Christians can through faith and hard work achieve the promise of immortality and become, like Christ, resurrected.

Scarry emphasizes the importance of work, and making, in the development of human civilization, discussing an essay by Frederick Engels which conjectures that the evolution of the human hand, rather than the human brain, was the quintessential factor in the emergence of Homo Sapiens. She cites the paleontologist Stephen Jay Goulds’ support for Engel’s conjecture, by means of the fossil record. Interestingly, Engels had in mind Lamarckian evolution, by which the discovery of tools putatively led to the inheritance of more facile hands, a hypothesis that has no basis in modern knowledge of genetics. However, beyond the limits of Scarry’s text, I would like here to point out that although the discovery of tools could not perhaps influence genes in the way Engels had in mind, learning to use them better and better from one generation to the next by means of a transmitted culture is not only credible but likely.

The idea that tools changed the shape of our hands becomes more convincing if we look at it through the lens one of Scarry’s other suggestions, that chairs were invented out of the carpenter’s sympathy for his companion, in order to reduce her pain. The preference to sit in a chair or on the floor appears to be entirely cultural. Some cultures prefer chair sitting, and others prefer floor sitting. But if you take a person from one culture and put them in the other, they become uncomfortable and might even experience pain or be physically unable to sit either on the floor or on a chair in the conventional manner, whichever one they are unaccustomed to. It is easy to see how chairs have changed the human body, in the culture where they are used!

This is probably the case not only for tools, but also for human language, which is represented in the brain in a region close to the one that codes hand movements and gestures, not movements of the mouth, and in fact in other primates seems to serve this function. Homo Sapiens probably existed for thousands of years before spoken language was invented, and when it was it changed our brains, just as written language has a specified brain region that serves some other function in cultures with no writing. Conversely, the language one speaks changes the shape of one’s face. As a child growing up in an international city I used to play a game on the bus with my father, where we guessed what language someone would speak before they opened their mouth. Different muscles are used to enunciate the sounds of different languages.

Scarry illustrates the role of the body in the writings of Karl Marx with the following metaphor. She describes a heap of shiny coal sitting on a large plain. Two men walk toward the heap of coal, and touch it. When one man touches the coal, his body starts to grow. It becomes vast, and as it grows one can see small scratches and gaping wounds growing on his skin, opening the inside of his body. When the other man touches the coal, he starts to vanish, in fact he disappears completely and becomes mere spiritual presence. The first man is the worker, and the second is the capitalist. The labor of the first man provides heat not for himself, but only for the second man, making him impervious to the physical insults of cold which are battering the first man. Elsewhere on the plain is a heap of money. The money is less material, less real than the coal. Five men on one side of the heap of money grow when they touch it, while one man on the other side evaporates and becomes an even louder spiritual voice. People gather at a third site, where there is only a scribbled note. Fifty men on one side of the scribbled note grow vast in their wounding, and one man on the other side vanishes completely and becomes so loud that his voice echoes over the plain, omnipresent in its demands, philosophies and laws.

It is easy to see that what Marx envisaged is a recapitulation of the troubling situation in the Judaic scriptures, where a disembodied voice (in this case, the philosophies and demands of the capitalist system) wound an entire body of people, whose pain goes unheeded, and whose imaginative creation (whether the commodities of material labor or the stories of their own origins) become severed from their original site in the human imagination and gain a power of their own, whereby they prevent the work of the human bodies from benefiting (reducing the pain) of the human bodies themselves. Just as in the biblical tale, the workers and the commodities they help produce by extending themselves through tools and lands (or raw materials) become seen to be created and governed by the capitalist society, instead of the reverse.

Like the earlier writings, Marx’s texts are filled with detailed lists and examples, replacing the earlier lists of who begat whom, and grounding them to factual reality using a similar rhetorical device consisting of lists that detail the particular terrible living and working conditions on one street in London, the numbers of people living in each room, the size of the room in inches (length, width, height) and the hours they each labor. Just as Christianity broke from Judaism, replacing the sign of the weapon with the sign of the healer, so it was perhaps also instrumental in causing a return to the former state of affairs by stimulating the obsessive preoccupation with making that led to the prevalence of circulating goods and eventually the invention of money and capital as the earthly manifestations of spiritual immortality.

Scarry brings these different texts, the Judaic scriptures, the Christian scriptures, and the writings of Karl Marx, to the fore because of the attention they all devote to “the problem of creating” as the more expansive context in which we should view “the problem of suffering”.