COVER STORY
The question for doctors: How do you spell relief?
The alarm rings at 7, and she reaches for the pillbox. It is the first act of her day. Her suffering, like the box itself, is divided into four spaces, each with its allotment of pink, white, brown and blue pills. "The pain is always there," she says; "there are just different levels of it. "First there is the "daily, hard, getting-around pain." This constant pain of rheumatoid arthritis has been with Maureen Hemmis, 37, since she was 18 years old. Then there is the variable pain: spots of acute, stabbing sensations that change location each day. Worst of all are the arthritic flare-ups when each joint rages and burns, hot to the touch. "The pain is everywhere. You can't be moved or touched. It's very much like being on fire."
In one way or another, we have all felt it. If it were a color, we would say it comes in a thousand shades, from vivid reds to somber browns. There is the quick, flashing smart of a ringer scorched by a flame or the grinding torment of the dentist's drill striking close to a nerve. We all know the dull throb of a stubbed toe that sends us hippity-hopping from foot to foot in search of distraction. And many have felt the pain that cuts deeper: the gut-clutching agony that we awaken to after surgery.
Though familiar to us all, pain is mercifully difficult to remember once it has passed (if it were not, it has been observed, every family would have but one child). Doctors refer to the short-lived suffering of childbirth or surgery or even a toothache as "acute pain"; it is terrible at the time, but ultimately it passes. For untold millions, however, pain does not pass. It sings on through the night, month after month, overwhelming sleep, stifling pleasure, shrinking experience, until there is nothing but pain. This is chronic pain, and its sufferers are legion: there are more than 36 million arthritics in the U.S.; there are 70 million with agonizing back pain; about 20 million who suffer from blinding migraines; millions more who are racked by diseases like sciatica and gout. Most feared of all, the pain associated with cancer afflicts some 800,000 Americans and 18 million people worldwide.
All told, nearly one-third of the American population have persistent or recurrent chronic pain, according to Seattle Anesthesiologist John Bonica, founder of the International Association for the Study of Pain and a world-renowned leader in pain research. Of these, he estimates, one-half to two-thirds are partly or totally disabled for periods of days, weeks or months, or for life. "Chronic pain disables more people than cancer or heart disease," says Bonica, "and it costs the American people more money than both." His estimate: $70 billion a year in medical costs, lost working days and compensation. The human cost, of course, cannot be measured. Shingles Sufferer
Mark Metcalf, 35, of Berkeley, Calif., endured weeks of pain that "felt like I had a hot iron held against the side of my neck," and he found himself "considering suicide as a rational alternative." Every year a number of the chronically suffering make that choice. Pain, said Albert Schweitzer, "is a more terrible lord of mankind than even death himself."
It is the single most