Why is pain necessary?

Marks of a Designer

Despite the obvious protective value of these millions of warning sensors, the pain network is easily the most unappreciated 653246 owiebodily system. It attracts mostly abuse and bad feelings. I have never read a poem extolling the virtues of pain, nor seen a statue erected in its honor, nor heard a hymn dedicated to it. Pain is usually defined as "unpleasantness."

Christians, who believe in a loving Creator, don't really know how to interpret pain. If pinned against the wall at a dark, secret moment, many Christians would confess that pain was God's one mistake. Really, he should have worked a little harder to devise a better way for us to cope with danger. I used to feel that way exactly.

Now, however, I am convinced that pain gets a bad press. Perhaps we should see poems, statues, and hymns to pain. Why has my attitude changed? Because up close, under a microscope, the pain network is seen in an entirely different light. My discussion of pain, then, must begin with a look at the human body. Why do I need pain? When I hurt, what is my body telling me?

I begin here, with the close-up view, because that perspective is the one most often overlooked by people fumbling with the question "Where is God when it hurts?" I have read scores of philosophical and theological books on "the problem of pain," but at best these give token acknowledgment to the fact that pain may serve some useful biological purpose.

The pain network deserves far more than token acknowledgment. It bears the mark of creative genius.

Consider a single organ from the human body: the skin, a flexible-yet-tough organ that stretches over the body's frame as an advance guard against the dangers of the outside world. Millions of pain sensors dot the surface of the skin, scattered not randomly, but in precise accord with the body's specific needs. Actually, the body does not seem to have any dedicated "pain cells," for the sensation of pain ties in with an elaborate network of sensors that also report information about pressure, touch, heat, and cold....

Colic, Kidney Stones, And Ice Cream Headache

Inside, the body presents even more evidence of the pain network's intelligent design. Pinpricks and heat burns, the scientists' favored techniques for measuring pain on the skin surface, prove useless on internal organs, which simply don't respond to those stimuli. Why should they? Since the body has designated the skin to sort through alarms from cuts and burns and pressures, internal organs can get along without such elaborate warnings systems.

Slip past the skin's defenses with the aid of a local anesthetic, and you could burn the stomach with a match, insert a needle through the lung, cut the brain with a knife, crush the kidney in a vise, or bore through bone, all without causing the patient any discomfort. Such internal pain signals would be redundant--the skin and skeleton already protect internal organs from such dangers.

Instead, the body's sheltered organs possess unique sets of pain receptors specific to the dangers they face. If a doctor inserts a balloon inside my stomach and fills it with air to distend my stomach slightly, urgent messages of pain would shoot to my brain--the pain of colic, or gas. The stomach's pain network is custom-designed to protect it from specific dangers. Likewise, the kidney sends out excruciating signals of pain when a BB-sized kidney stone is present. Linings of the joints, which are insensitive to a needle or knife, are very sensitive to certain chemicals.

On rare occasions, an internal organ must inform the brain of an emergency that its pain sensors are not equipped to handle. How can it alert the brain to the damage it senses?

In this event, the organ uses the remarkable phenomenon of referred pain, recruiting nearby pain sensors to sound the alarm. For example, heart attack victims may notice a burning or constricting feeling in the neck, chest, jaw, or left arm. Skin cells there, though perfectly healthy, obligingly send off alarm messages to the brain as if they were damaged, when in fact the problem lies with their neighbor the heart. In this way the skin "loans" its pain sensors to the heart as a relay warning station.

Anyone who has eaten homemade ice cream too fast on a hot summer day may experience a related phenomenon. Suddenly a headache strikes, just behind the eyes. Quite obviously, ice cream is not entering the forehead. Rather, the stomach's vagus nerve is sending out strong signals of cold to the brain; at the junction with the trigeminal nerve from the face, forehead, and jaw, pain jumps across from one nerve to the other and the chill in the stomach is felt as pain in the head.

The mystery of referred pain can make for some challenging medical diagnoses.

Spleen injuries are sometimes felt in the tip of the left shoulder. A damaged appendix may borrow pain sensors in a variety of places, on either side of the abdomen. A neck injury may cause pain in the arm. Each of these demonstrates how the body's backup systems cooperate to warn of possible injury.

Medical libraries contain massive volumes filled with amazing facts about the operation of the body's pain network, and I have mentioned a mere sampling. Such facts as these--the exact distribution of needed pain cells, the customized pressure/pain thresholds, and the backup system of referred pain--convince me that, whatever it is, the pain network is not an accident.

Pain is not an afterthought, or God's great goof. Rather, it reveals a marvelous design that serves our bodies well. Pain is as essential to a normal life, it could be argued, as eyesight or even good circulation. Without pain, as we shall see, our lives would be fraught with danger, and devoid of many basic pleasures.

But Must It Hurt?

My appreciation for the engineering aspects of the pain network traces back to the beginning of my friendship with Dr. Paul Brand. I came across his name in 1975, when I was first researching the topic of pain. Already I had read many books on the subject. But one day my wife, who was rummaging through a closet at a medical supply house, came across a pamphlet with the unusual title, "The Gift of Pain." Its author was Dr. Brand. A short time later, we met together on the grounds of the leprosarium in Carville, Louisiana, and since then we have collaborated on two books (Fearfully and Wonderfully Made and In His Image).

Dr. Brand has received widespread recognition for his medical work, including awards from the Albert Lasker Foundation, the U.S. Public Health Service, and also from Queen Elizabeth II, who made him Commander of the British Empire. Yet, oddly, he got most of his recognition as a crusader on behalf of pain. Without hesitation Dr. Brand declares, "Thank God for inventing pain! I don't think he could have done a better job. It's beautiful." As one of the world's foremost experts on leprosy, a disease of the nervous system, he is well-qualified to make such a judgment.

Once, in fact, Dr. Brand received a several-million-dollar grant for the express purpose of designing an artificial pain system. He knew that people with diseases like leprosy and diabetes were in grave danger of losing fingers, toes, and even entire limbs simply because their warning system of pain had been silenced. They were literally destroying themselves unawares. Perhaps he could design a simple substitute that would alert them to the worst dangers.

In this project Dr. Brand had to think like the Creator, anticipating the needs of the body. For assistance, he signed on three professors of electronic engineering, a bioengineer, and several research biochemists. The team decided to concentrate on fingertips, the part of the body most often used and therefore most vulnerable to abuse. They developed a kind of artificial nerve, a pressure sensitive transducer that could be worn on the finger like a glove. When subjected to pressure, the electronic nerve triggered an electric current which in turn set off a warning signal.

Dr. Brand and his assistants confronted daunting technical problems. The more they studied nerves, the more complex their task appeared. At what level of pressure should the sensor sound a warning? How could a mechanical sensor distinguish between the acceptable pressure of, say, gripping a railing and the unacceptable pressure of gripping a thorn bush? How could it be adjusted to allow for rigorous activities like playing tennis?

Brand also recognized that nerve cells change their perception of pain to meet the body's needs. Due to the pressure of inflammation, an infected finger may become ten times more sensitive to pain. That's why a finger swollen from a hangnail feels awkward and in the way: your body is telling you to give it time to heal. Nerve cells "turn up the volume," amplifying bumps and scrapes that would normally go unreported. In no way could these well-funded scientists duplicate that feat with current technology.

The artificial sensors cost about $450 each, and it took many of them to protect a single hand or foot, but each new design would deteriorate from metal fatigue or corrosion after a few hundred uses. Each month Dr. Brand and his colleagues gained more appreciation for the remarkable engineering of the body's pain network, which includes several hundred million sensors that function maintenance-free throughout a healthy person's life.

At first Dr. Brand sought a way to make his artificial pain system work without actually hurting the patient.

He had read the complaints of various philosophers against the created world. Why hadn't God designed a nervous system that protects us, but without the unpleasant aspects of pain? Here was his chance to improve on the original design with a protective system that did not hurt.

First his team tried sending an audible signal through a hearing aid, a signal that would hum when tissues were receiving normal pressures and buzz loudly when they were actually in danger. But the signal proved too easy to ignore. If a patient with a damaged hand was turning a screwdriver too hard, and the loud warning signal went off, he would simply override it and turn the screwdriver anyway. This happened not once, but many times. People who did not feel pain could not be persuaded to trust the artificial sensors.

Brand's team next tried blinking lights, but soon eliminated them for the same reason. Finally they had to resort to electric shock, taping electrodes to a still-sensitive portion of the body, such as the armpit. People had to be forced to respond; being alerted to the danger was not enough. The stimulus had to be unpleasant, just as pain is unpleasant.

"We also found out that the signal had to be out of the patient's reach," Brand says. "For even intelligent people, if they wished to do something which they were afraid would activate the shock, would switch off the signal, do what they had in mind to do, and then switch it on again when there was no danger of receiving an unpleasant signal. I remember thinking how wise God had been in putting pain out of reach."

After five years of work, thousands of man-hours, and several million dollars, Brand and his associates abandoned the entire project. A warning system suitable for just one hand was exorbitantly expensive, subject to frequent mechanical breakdown, and hopelessly inadequate to interpret the profusion of sensations. A system sometimes called "God's great mistake" was far too complex for even the most sophisticated technology to mimic.

That is why Paul Brand says with utter sincerity, "Thank God for pain!" By definition, pain is unpleasant, enough so to force us to withdraw our fingers from a stove. Yet that very quality saves us from destruction. Unless the warning signal demands response, we might not heed it.

Listen to Your Pain

The typical American response to pain is to take an aspirin at the slightest ache and silence the pain. That approach only deals with the symptom of the problem. We dare not shut off the warning system without first listening to the warning.

A tragic example of someone not heeding the warning occurred in an NBA basketball game in which a star player, Bob Gross, wanted to play despite a badly injured ankle. Knowing that Gross was needed for the important game, the team doctor injected Marcaine, a strong painkiller, into three different places of his foot. Gross did start the game, but after a few minutes, as he was battling for a rebound, a loud snap! could be heard throughout the arena. Gross, oblivious, ran up and down the court two times, then crumpled to the floor. Although he felt no pain, a bone had broken in his ankle. By overriding pain's warning system with the anesthetic, the doctor caused permanent damage to Gross's foot and ended his basketball career.

Pain is not God's great goof. The sensation of pain is a gift--the gift that nobody wants....

I do not say that all pain is good. Sometimes it flares up and makes life miserable. For someone with crippling arthritis or terminal cancer, pain dominates so much that any relief, especially a painless world, would seem like heaven itself. But for the majority of us, the pain network performs daily protective service. It is effectively designed for surviving life on this sometimes hostile planet.

In Dr. Brand's words, "The one legitimate complaint you can make against pain is that it cannot be switched off. It can rage out of control, as with a terminal cancer patient, even though its warning has been heard and there is no more that can be done to treat the cause of pain. But as a physician I'm sure that less than one percent of pain is in this category that we might call out of control. Ninety-nine per cent of all the pains that people suffer are short-term pains: correctable situations that call for medication, rest, or a change in a person's lifestyle."

Admittedly, the surprising idea of the "gift of pain" does not answer many of the problems connected with suffering. But it is a beginning point of a realistic perspective on pain and suffering. Too often the emotional trauma of intense pain blinds us to its inherent value.

When I break an arm and swallow bottles of aspirin to dull the ache, gratitude for pain is not the first thought that comes to mind. Yet at that very moment, pain is alerting my body to the danger, mobilizing anti-infection defenses around the wound, and forcing me to refrain from activities that might further compound the injury. Pain demands the attention that is crucial to my recovery.

Taken from Where Is God When It Hurts? by Philip Yancey. Copyright © 1977, 1990 by Philip Yancey. Used by permission of Zondervan Publishing House.

This material has been taken from: Eternal Security: Can You Be Sure?
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