Understandingnocioception: the Rhetorical Languageof Pain

Since the onset of theWesternmedical practitioner in the late 14th century, medicine has depended on rhetoric to persuade a skeptical audience of the legitimacy of its claims. Initially, the very status of the practitioner depended on his or her abilities to persuade the clientele. However, during the rise of the 17th century Galilean scientific revolution, the authority of medicine was increasingly established through the practice of sound, scientific methodology, thereby slowly marginalizing the rhetorical relationship between the physician and the patient (Momigliano 87-89). Science replaced art, and the core of medical theory became shaped by scientific progressivism that still exists today. There are certain medical phenomena, however, that defy the traditional notion of scientific absolutism and bring forth a new dependence on rhetoric in the patient/doctor dyad. John Ioannidis’s recent study shows that approximately one-third of highly-cited, original research studies were either contradicted or expanded upon by subsequent studies (218). Ambiguities and irregularities such as these can confound physicians’ efforts to appropriately treat a patient’s afflictions. One example of this is a medical phenomenon termed the pain perplex. According to Atul Gawande, the pain perplex is defined as the mental sensation of pain without a justifiable or recognizable cause (99). Currently, the two most prolific examples of the pain perplex are phantom limb pain and chronic pain, both of which are diagnosed at alarming rates in the United States (Rosenfeld 119). When faced with this phenomenon, the physician is forced to rely less on scientific theory and more on the patient and the humanistic components of their affliction. To treat the ailment, the physician is obligated to treat the mental pain based on the patient’s description. The patient must provide a coherent and accurate account of his pain, and the physician thenmatches the patient’s assessment with her professional understanding of pain. During this process, the actuality of the pain response is almost always lost in the efforts to reproduce its feeling in human language. Thus, the physician must be able to interpret a patient’s rhetorical argument in order to utilize language as a vehicle of treatment. Rhetoric has become more essential to the quality of life for the patient. Together, pain and rhetoric have created a complex and intricate component of preventative medicine that has revolutionized primary care. Using patients’ narratives, this essay analyzes the rhetoric used to recreate chronic, acute, phasic and post-operative pain and suffering. The rhetorical analysis of these narratives will help map a preliminary understanding of the role of rhetoric in treating a patient and the developing partnership between medical science and rhetoric.