The Pain Perplex Summary and Analysis

Doctors have long been puzzled by chronic pain in patients. Gawande admits that sometimes doctors are dismissive of pain, or in general, symptoms that cannot be corroborated by a diagnostic test. Indeed there are many aspects of pain that are puzzling—sometimes pain increases when a patient is anxious, conversely sometimes it disappears when a patient is distracted or in a good mood. Doctors are programmed to look for a physical explanation—a lesion, structural abnormality, muscle tear, however, studies have not been able to discern the reason for chronic pain.

Gawande discusses the case of Rowland Scott Quinlan, an architect who suffers from crippling back pain. Diagnostic tests failed to identify a physical explanation of the pain. In fact, the pain started months after he suffered an injury to his shoulder. Gawande talks to...