A History of Pain From Ether to the Opioid Crisis

Imagine you are lying on a wooden table in the year 1844. A surgeon stands over you with a saw. You are about to have your leg amputated above the knee. There is no anesthesia. There is no relief. There is only the knowledge that if you survive the next four minutes — and four minutes is roughly how long a skilled surgeon needs — you will have made it through one of the most agonizing experiences a human body can endure. The fastest surgeons in 19th-century London were celebrated not for their precision but for their speed. Robert Liston, the so-called fastest knife in the West End, could remove a limb in under thirty seconds. He was a hero. And he was a hero because speed was mercy. Speed was the only anesthesia available.

Now imagine you are lying in a hospital bed in the year 1996. A pharmaceutical sales representative has just visited your doctor. The sales rep left behind brochures, samples, and a simple message: a new drug called OxyContin offers twelve hours of relief, is highly effective, and carries a low risk of addiction. Your doctor believes this. The FDA approved it. The medical establishment endorsed it. Within a decade, more than two hundred thousand Americans will have died from opioid overdoses. The miracle cure will become its own catastrophe.

These two scenes, separated by a hundred and fifty years, are both chapters in the same story. It is the story of humanity's long, desperate, and often catastrophic attempt to understand pain — to see it, measure it, explain it, and finally conquer it. It is a story about science and philosophy and the limits of what one person can ever truly know about what another person is feeling. It is, in other words, one of the most human stories ever told.